Provider Demographics
NPI:1639690373
Name:ACUPUNCTURE AND ORIENTAL SPORTS MEDICINE INC.
Entity Type:Organization
Organization Name:ACUPUNCTURE AND ORIENTAL SPORTS MEDICINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WOOK
Authorized Official - Middle Name:
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:813-340-3005
Mailing Address - Street 1:7032 W HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-4948
Mailing Address - Country:US
Mailing Address - Phone:813-399-1195
Mailing Address - Fax:
Practice Address - Street 1:7032 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4948
Practice Address - Country:US
Practice Address - Phone:813-399-1195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3812261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty