Provider Demographics
NPI:1578010112
Name:WELLNESS HEALTH ACUPUNCTURE & PHYSICAL THERAPY
Entity Type:Organization
Organization Name:WELLNESS HEALTH ACUPUNCTURE & PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:YVES
Authorized Official - Middle Name:MICHEL
Authorized Official - Last Name:SURIN
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:407-967-1056
Mailing Address - Street 1:899 CAVAN DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-8344
Mailing Address - Country:US
Mailing Address - Phone:407-967-1056
Mailing Address - Fax:
Practice Address - Street 1:340 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2644
Practice Address - Country:US
Practice Address - Phone:407-347-9576
Practice Address - Fax:407-347-9598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3737261Q00000X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy