Provider Demographics
NPI:1164074837
Name:BRONZE MAN ACUPUNCTURE INC.
Entity Type:Organization
Organization Name:BRONZE MAN ACUPUNCTURE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPOUX
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AP
Authorized Official - Phone:561-367-5008
Mailing Address - Street 1:830 NE 40TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3014
Mailing Address - Country:US
Mailing Address - Phone:954-404-2735
Mailing Address - Fax:
Practice Address - Street 1:4594 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-4515
Practice Address - Country:US
Practice Address - Phone:561-367-5008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty