Provider Demographics
NPI:1861636284
Name:PAU, GRACE WAI MUN (AP)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:WAI MUN
Last Name:PAU
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 N.E. 126 STREET
Mailing Address - Street 2:STE 101
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161
Mailing Address - Country:US
Mailing Address - Phone:305-401-6789
Mailing Address - Fax:954-704-2853
Practice Address - Street 1:888 N.E. 126 STREET
Practice Address - Street 2:STE 101
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161
Practice Address - Country:US
Practice Address - Phone:305-401-6789
Practice Address - Fax:954-704-2853
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0000107171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist