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NPI Code Detail

MEDICARE: MR. KEITH MICHAEL PARMENTER D.O.M

MEDICARE:  MR. KEITH MICHAEL PARMENTER  D.O.M
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistAP2103FL

General Provider Information

NPI Number : 1104026418
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KEITH MICHAEL PARMENTER D.O.M
Provider Business Mailing Address
First Line : 160 SW 12TH AVE
Second Line : 102
City : DEERFIELD BEACH
State : FL
Zip : 33442-3119
Country : US
Telephone Number : 954-574-5277
Fax Number : 954-574-5228
Provider Business Practice Location Address
First Line : 160 SW 12TH AVE
Second Line : 102
City : DEERFIELD BEACH
State : FL
Zip : 33442-3119
Country : US
Telephone Number : 954-574-5277
Fax Number : 954-574-5228
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2007
Last Update Date : 12/06/2012

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