Provider Demographics
NPI:1457685646
Name:ALTERNATIVE HEALTH THERAPIES, INC
Entity Type:Organization
Organization Name:ALTERNATIVE HEALTH THERAPIES, INC
Other - Org Name:MAYDA CARRILLO. RN,DOM NMD
Other - Org Type:Other Name
Authorized Official - Title/Position:REGISTERED NURSE,ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYDA
Authorized Official - Middle Name:ENGRACIA
Authorized Official - Last Name:CARRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:RN,LAP,DOM, NMD
Authorized Official - Phone:727-449-9090
Mailing Address - Street 1:1201 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-1430
Mailing Address - Country:US
Mailing Address - Phone:727-449-9090
Mailing Address - Fax:727-449-9090
Practice Address - Street 1:1201 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-1430
Practice Address - Country:US
Practice Address - Phone:727-449-9090
Practice Address - Fax:727-449-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1451192261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service