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General NPI Number Information
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NPI Number | 1740684000
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Entity Type | Organization
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Legal Business Name | MEDICINE MAN MEDICAL CENTER OF SOUTH FLORIDA, INC.
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Dates
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Enumeration Date | 10/15/2014
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 14471 S DIXIE HWY
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City | MIAMI
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State | FL
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Zip | 33176-7924
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Country | US
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Telephone | 786-573-4777
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Fax | 786-573-4887
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Provider Business Mailing Address
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Address Line | 14471 S DIXIE HWY
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City | MIAMI
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State | FL
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Zip | 33176-7924
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Country | US
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Telephone | 786-573-4777
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Fax | 786-573-4887
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | KAREN SALSTEIN BEGLEY
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Credential |
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Telephone | 786-287-6461
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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 | AP 3556
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License Number State | FL
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