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General NPI Number Information
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NPI Number | 1477134229
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Entity Type | Organization
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Legal Business Name | BUENA VIDA ACUPUNCTURE PROJECT LLC
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Dates
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Enumeration Date | 04/14/2021
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Last Update Date | 04/14/2021
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Provider Practice Location Address
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Address Line | 12251 AUGUSTA WOODS CIR
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City | ORLANDO
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State | FL
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Zip | 32824-9051
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Country | US
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Telephone | 407-491-4618
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Fax |
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Provider Business Mailing Address
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Address Line | 12251 AUGUSTA WOODS CIR
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City | ORLANDO
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State | FL
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Zip | 32824-9051
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Country | US
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Telephone | 407-491-4618
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACQUELINE TORRELLAS
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Credential | D.O.M. L AC
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Telephone | 407-491-4618
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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 |
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License Number State |
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