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General NPI Number Information
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NPI Number | 1417470675
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Entity Type | Organization
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Legal Business Name | PRO HEALTH ACUPUNCTURE
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 07/19/2017
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Provider Practice Location Address
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Address Line | 1275 W 47TH PL STE 316
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City | HIALEAH
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State | FL
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Zip | 33012-3448
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Country | US
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Telephone | 786-218-8754
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Fax |
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Provider Business Mailing Address
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Address Line | 1275 W 47TH PL STE 316
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City | HIALEAH
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State | FL
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Zip | 33012-3448
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | BELKIS DIAZ
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Credential | LAC
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Telephone | 786-218-8754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP2992
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License Number State | FL
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