Provider Demographics
NPI:1477019859
Name:LEAF INTEGRATIVE ACUPUNCTURE
Entity Type:Organization
Organization Name:LEAF INTEGRATIVE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:ESTELLA
Authorized Official - Last Name:JARAMILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-716-4934
Mailing Address - Street 1:22095 ARARAT ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-4162
Mailing Address - Country:US
Mailing Address - Phone:561-716-4934
Mailing Address - Fax:
Practice Address - Street 1:346 ESPLANADE # 57
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-4918
Practice Address - Country:US
Practice Address - Phone:561-716-4934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service