Provider Demographics
NPI:1265701478
Name:DAVID NEVINS ACUPUNCTURE, INC
Entity type:Organization
Organization Name:DAVID NEVINS ACUPUNCTURE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:ACUPUNCTURIST
Authorized Official - Phone:305-725-1152
Mailing Address - Street 1:19212 NE 25TH AVE APT 282
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3218
Mailing Address - Country:US
Mailing Address - Phone:305-725-1152
Mailing Address - Fax:305-940-7249
Practice Address - Street 1:17027 W DIXIE HWY STE 108
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3715
Practice Address - Country:US
Practice Address - Phone:305-725-1152
Practice Address - Fax:305-940-7949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 1529171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty