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General NPI Number Information
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NPI Number | 1760722193
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE BY M
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Dates
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Enumeration Date | 02/21/2013
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Last Update Date | 02/21/2013
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Provider Practice Location Address
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Address Line | 900 MERIDIAN AVE SUITE 105
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City | MIAMI BEACH
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State | FL
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Zip | 33139
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Country | US
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Telephone | 203-994-0789
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 192331
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City | MIAMI BEACH
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State | FL
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Zip | 33119
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Country | US
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Telephone | 203-994-0789
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST PHYSICIAN
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Name | MELISSA FORNABIA
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Credential | DOM
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Telephone | 203-994-0789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 3129
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License Number State | FL
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