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General NPI Number Information
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NPI Number | 1629679022
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Entity Type | Organization
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Legal Business Name | DORAL ACUPUNCTURE LLC
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 3399 NW 72ND AVE STE 224
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City | MIAMI
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State | FL
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Zip | 33122-1344
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Country | US
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Telephone | 305-903-9364
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Fax |
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Provider Business Mailing Address
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Address Line | 3250 SW 20TH ST
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City | MIAMI
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State | FL
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Zip | 33145-2254
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Country | US
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Telephone | 305-903-9364
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | VICTORIA CANDELA FERNANDEZ
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Credential |
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Telephone | 305-903-9364
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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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