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General NPI Number Information
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NPI Number | 1508270059
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Entity Type | Individual
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Provider Name | MAX DUPOUX LIC. AP
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Gender | Male
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 4594 N UNIVERSITY DR
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City | LAUDERHILL
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State | FL
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Zip | 33351-4515
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Country | US
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Telephone | 561-367-5008
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Fax |
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Provider Business Mailing Address
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Address Line | 830 NE 40TH ST
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3014
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Country | US
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Telephone | 954-404-2735
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AP2923
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License Number State | FL
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