Provider Demographics
NPI:1871862169
Name:ASIAN THERAPIES LLC
Entity Type:Organization
Organization Name:ASIAN THERAPIES LLC
Other - Org Name:ASIAN THERAPIES ACUPUNCTURE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:GALINA
Authorized Official - Middle Name:V
Authorized Official - Last Name:ROOFENER
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:727-744-4925
Mailing Address - Street 1:4235 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8230
Mailing Address - Country:US
Mailing Address - Phone:727-744-4925
Mailing Address - Fax:
Practice Address - Street 1:4235 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8230
Practice Address - Country:US
Practice Address - Phone:727-744-4925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2638261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1821235516OtherNPI
MOC4369OtherBCBS