Provider Demographics
NPI:1164842969
Name:TAMPA HYPNOTIC AWAKENING
Entity Type:Organization
Organization Name:TAMPA HYPNOTIC AWAKENING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CH, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IGNACIO
Authorized Official - Middle Name:VLADIMIR
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:CH
Authorized Official - Phone:813-377-9214
Mailing Address - Street 1:5906 ARGERIAN DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-4222
Mailing Address - Country:US
Mailing Address - Phone:813-377-9214
Mailing Address - Fax:813-365-3074
Practice Address - Street 1:5906 ARGERIAN DR
Practice Address - Street 2:SUITE 102
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-4222
Practice Address - Country:US
Practice Address - Phone:813-377-9214
Practice Address - Fax:813-365-3074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty