=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750045506
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RONA YOUNOS L.AC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2021
-----------------------------------------------------
Last Update Date | 10/27/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8527 PINES BLVD STE 208
-----------------------------------------------------
City | PEMBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33024-6668
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-789-9032
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 43 CHESTNUT CIR
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33026-1141
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-789-9032
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AP3600
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------