Provider Demographics
NPI:1942618772
Name:ESSENTIAL ACUPUNCTURE AND WELLNESS
Entity Type:Organization
Organization Name:ESSENTIAL ACUPUNCTURE AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVA
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:305-632-5351
Mailing Address - Street 1:7028 MINDELLO ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6232
Mailing Address - Country:US
Mailing Address - Phone:305-632-5351
Mailing Address - Fax:
Practice Address - Street 1:7028 MINDELLO ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33143-6232
Practice Address - Country:US
Practice Address - Phone:305-632-5351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty