Provider Demographics
NPI:1881839074
Name:A CENTER FOR ALTERNATIVE MEDICINE AND SPA
Entity Type:Organization
Organization Name:A CENTER FOR ALTERNATIVE MEDICINE AND SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:LEGUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-428-6999
Mailing Address - Street 1:40 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1854
Mailing Address - Country:US
Mailing Address - Phone:954-428-6999
Mailing Address - Fax:
Practice Address - Street 1:40 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1854
Practice Address - Country:US
Practice Address - Phone:954-428-6999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM13444261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service