Provider Demographics
NPI:1134642101
Name:GAINESVILLE ACUPUNCTURE & HOLISTIC MEDICINE
Entity Type:Organization
Organization Name:GAINESVILLE ACUPUNCTURE & HOLISTIC MEDICINE
Other - Org Name:GAINESVILLE ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:
Authorized Official - Last Name:PORRAS TOLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:352-672-1181
Mailing Address - Street 1:3825 SW 100TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-9041
Mailing Address - Country:US
Mailing Address - Phone:352-672-1181
Mailing Address - Fax:352-559-2363
Practice Address - Street 1:4040 NEWBERRY RD STE 1500
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2393
Practice Address - Country:US
Practice Address - Phone:352-672-1181
Practice Address - Fax:352-559-2363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-21
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3373171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty