Provider Demographics
NPI:1679748172
Name:ACUPUNCTURE & HOLISTIC HEALTH CENTER
Entity Type:Organization
Organization Name:ACUPUNCTURE & HOLISTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES./OWNER ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:HODGSON
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:813-841-1515
Mailing Address - Street 1:12209 WOOD DUCK PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-1300
Mailing Address - Country:US
Mailing Address - Phone:813-841-1515
Mailing Address - Fax:
Practice Address - Street 1:6967 E FOWLER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-1714
Practice Address - Country:US
Practice Address - Phone:813-989-9771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP000977171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty