Provider Demographics
NPI:1487192431
Name:PERFECT BLEND ACUPUNCTURE
Entity Type:Organization
Organization Name:PERFECT BLEND ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:HEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:941-321-7171
Mailing Address - Street 1:4235 LANCASTER DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-5722
Mailing Address - Country:US
Mailing Address - Phone:941-321-7171
Mailing Address - Fax:
Practice Address - Street 1:1905 BAYWOOD DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-4716
Practice Address - Country:US
Practice Address - Phone:941-321-7171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3697171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty