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General NPI Number Information
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NPI Number | 1932377017
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Entity Type | Individual
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Provider Name | JAIME TINOCO ACUPUNCTURIST
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Gender | Male
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 500 SE 17TH ST STE # 220
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2547
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Country | US
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Telephone | 954-682-5814
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Fax | 954-922-8050
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Provider Business Mailing Address
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Address Line | 1455 YELLOWHEART WAY
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City | HOLLYWOOD
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State | FL
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Zip | 33019-4859
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Country | US
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Telephone | 954-682-5814
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Fax | 954-920-8013
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AP00435
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License Number State | FL
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