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General NPI Number Information
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NPI Number | 1922535046
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Entity Type | Organization
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Legal Business Name | BENSHEN ACUPUNCTURE AND HERBS
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Dates
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Enumeration Date | 05/19/2017
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 2150 S ANDREWS AVE STE 201
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-3497
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Country | US
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Telephone | 954-533-8044
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Fax |
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Provider Business Mailing Address
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Address Line | 2150 S ANDREWS AVE STE 201
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-3497
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Country | US
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Telephone | 954-465-6531
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURE PHYSICIAN
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Name | MRS. CRYSTAL L CACOLICI
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Credential | A.P. L.A.C.
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Telephone | 954-533-8044
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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 | AP3644
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License Number State | FL
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