Provider Demographics
NPI:1851424048
Name:CENTER FOR ACUPUNCTURE & INTEGRATIVE MEDICINE, LLC
Entity Type:Organization
Organization Name:CENTER FOR ACUPUNCTURE & INTEGRATIVE MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:772-564-8383
Mailing Address - Street 1:2050 40TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-2467
Mailing Address - Country:US
Mailing Address - Phone:772-564-8383
Mailing Address - Fax:772-564-8377
Practice Address - Street 1:2050 40TH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-2467
Practice Address - Country:US
Practice Address - Phone:772-564-8383
Practice Address - Fax:772-564-8377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2284171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty