Provider Demographics
NPI:1265826663
Name:MARINO ACUPUNCTURE & WELLNESS
Entity Type:Organization
Organization Name:MARINO ACUPUNCTURE & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:CANCELA
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:239-961-3330
Mailing Address - Street 1:700 SE 9TH ST
Mailing Address - Street 2:UNIT 304
Mailing Address - City:DANIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33004-5366
Mailing Address - Country:US
Mailing Address - Phone:239-961-3330
Mailing Address - Fax:
Practice Address - Street 1:1205 PIPER BLVD
Practice Address - Street 2:STE 103
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1387
Practice Address - Country:US
Practice Address - Phone:239-961-3330
Practice Address - Fax:206-203-1186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP-2079171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty