=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457579997
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A SUPER HEALTH CARE CENTER,INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/22/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15300 JOG RD SUITE 209
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33446-2162
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-381-3303
-----------------------------------------------------
Fax | 954-753-6681
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15300 JOG RD SUITE 209
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33446-2162
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-381-3303
-----------------------------------------------------
Fax | 954-753-6681
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. HAN MING DU
-----------------------------------------------------
Credential | AP
-----------------------------------------------------
Telephone | 561-381-3303
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AP0000968
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------