Provider Demographics
NPI:1356858526
Name:ELEGANT HEALING LLC
Entity Type:Organization
Organization Name:ELEGANT HEALING LLC
Other - Org Name:ELEGANT HEALING ACUPUNCTURE & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:YOMARI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, AP
Authorized Official - Phone:239-273-9012
Mailing Address - Street 1:PO BOX 522
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33929-0522
Mailing Address - Country:US
Mailing Address - Phone:239-273-9012
Mailing Address - Fax:
Practice Address - Street 1:17595 S TAMIAMI TRL STE 219
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4889
Practice Address - Country:US
Practice Address - Phone:239-273-9012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3885171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherIRS