Provider Demographics
NPI:1356508550
Name:PALM ACUPUNCTURE, INC
Entity Type:Organization
Organization Name:PALM ACUPUNCTURE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, AP
Authorized Official - Phone:239-939-4299
Mailing Address - Street 1:1361 ROYAL PALM SQUARE BLVD
Mailing Address - Street 2:UNIT 4
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-1027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1361 ROYAL PALM SQUARE BLVD
Practice Address - Street 2:UNIT 4
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-1027
Practice Address - Country:US
Practice Address - Phone:239-939-4299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2054171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty