Provider Demographics
NPI:1013344373
Name:BLACK PEARL ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:BLACK PEARL ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BATTLE
Authorized Official - Suffix:
Authorized Official - Credentials:AP,DOM
Authorized Official - Phone:772-202-2820
Mailing Address - Street 1:8701 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-7570
Mailing Address - Country:US
Mailing Address - Phone:772-202-2820
Mailing Address - Fax:
Practice Address - Street 1:8701 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-7570
Practice Address - Country:US
Practice Address - Phone:772-202-2820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2557171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty