Provider Demographics
NPI:1255581500
Name:ABLE ACUPUNCTURE
Entity type:Organization
Organization Name:ABLE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOURGOUIN
Authorized Official - Suffix:
Authorized Official - Credentials:AP, DOM
Authorized Official - Phone:954-394-4038
Mailing Address - Street 1:2015 MADISON ST
Mailing Address - Street 2:202
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6974
Mailing Address - Country:US
Mailing Address - Phone:954-394-4038
Mailing Address - Fax:954-239-5433
Practice Address - Street 1:2015 MADISON ST
Practice Address - Street 2:202
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6974
Practice Address - Country:US
Practice Address - Phone:954-394-4038
Practice Address - Fax:954-239-5433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2457251B00000X, 251E00000X, 251V00000X, 261QC1800X, 261QM1200X, 261QM1300X, 261QP2000X, 261QR0800X, 261QU0200X, 273Y00000X, 275N00000X, 276400000X, 291U00000X, 305S00000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251V00000XAgenciesVoluntary or Charitable
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No273Y00000XHospital UnitsRehabilitation Unit
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No291U00000XLaboratoriesClinical Medical Laboratory
No305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1316136864OtherNPI FOR MICHELE BOURGOUIN