Provider Demographics
NPI:1265822332
Name:INSIGHT ACUCLINIC, INC.
Entity Type:Organization
Organization Name:INSIGHT ACUCLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PAKULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-260-9757
Mailing Address - Street 1:1321 NW 139TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-3022
Mailing Address - Country:US
Mailing Address - Phone:954-260-9757
Mailing Address - Fax:954-217-6990
Practice Address - Street 1:1321 NW 139TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-3022
Practice Address - Country:US
Practice Address - Phone:954-260-9757
Practice Address - Fax:954-217-6990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3614261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care