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General NPI Number Information
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NPI Number | 1922470137
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Entity Type | Organization
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Legal Business Name | 72 WELLNESS CENTER
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 2925 AVENTURA BLVD STE 306
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City | AVENTURA
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State | FL
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Zip | 33180-3109
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Country | US
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Telephone | 786-715-4609
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 AVENTURA BLVD STE 306
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City | AVENTURA
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State | FL
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Zip | 33180-3109
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Country | US
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Telephone | 786-715-4609
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Fax |
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Authorized Official
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Title or Position | PRESIDENT , ACUPUNCTURIST
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Name | MR. ABEL FIGUEREDO
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Credential | LAC.
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Telephone | 786-715-4609
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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 2739
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License Number State | FL
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