MEDICARE: ACUPUNTURE HOLISTIC MEDCINE RA INC

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
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1811468325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUPUNTURE HOLISTIC MEDCINE RA INC

Provider Business Mailing Address
First Line	:	2450 SW 137TH AVE STE 207
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6312
Country	:	US
Telephone Number	:	786-464-0955
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 SW 137TH AVE STE 207
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6312
Country	:	US
Telephone Number	:	786-464-0955
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RAIDA L RODRIGUEZ
Credential	:	AP
Telephone Number	:	786-464-0955

Provider Enumeration Date	:	12/10/2018
Last Update Date	:	12/14/2018

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