Provider Demographics
NPI:1225301344
Name:THREE TREASURES ACUPUNCTURE, LLC
Entity Type:Organization
Organization Name:THREE TREASURES ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ODIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-564-1881
Mailing Address - Street 1:1298 NE 33RD ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-4510
Mailing Address - Country:US
Mailing Address - Phone:786-564-1881
Mailing Address - Fax:
Practice Address - Street 1:1650 NE 26TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1431
Practice Address - Country:US
Practice Address - Phone:786-564-1881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2616171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty