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General NPI Number Information
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NPI Number | 1861156135
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE AND HOLISTIC WELLNESS CENTER, INC
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Dates
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Enumeration Date | 10/23/2021
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Last Update Date | 10/23/2021
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Provider Practice Location Address
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Address Line | 6447 MIAMI LAKES DR STE 210F
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2765
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Country | US
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Telephone | 786-873-2573
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Fax |
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Provider Business Mailing Address
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Address Line | 9127 WHISTABLE WALK
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City | TAMARAC
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State | FL
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Zip | 33321-4172
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Country | US
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Telephone | 786-873-2573
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARIO G MARINI
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Credential |
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Telephone | 786-873-2573
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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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