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General NPI Number Information
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NPI Number | 1982787743
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Entity Type | Individual
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Provider Name | MARCUS SMITH AP, L.AC, MSOM
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 11/16/2017
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Provider Practice Location Address
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Address Line | 2929 N UNIVERSITY DR SUITE 204
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5081
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Country | US
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Telephone | 954-907-1036
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Fax |
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Provider Business Mailing Address
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Address Line | 1440 CORAL RIDGE DR #379
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-5433
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Country | US
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Telephone | 954-907-1036
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Fax |
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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 | AP1954
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License Number State | FL
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