Provider Demographics
NPI:1457170102
Name:FUNCTIONAL NATURAL ACUPUNCTURE, LLC
Entity type:Organization
Organization Name:FUNCTIONAL NATURAL ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:E
Authorized Official - Last Name:ARMOZA
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:516-815-6674
Mailing Address - Street 1:1103 W HIBISCUS BLVD STE 309B
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-2717
Mailing Address - Country:US
Mailing Address - Phone:321-830-5033
Mailing Address - Fax:
Practice Address - Street 1:1103 W HIBISCUS BLVD STE 309B
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2717
Practice Address - Country:US
Practice Address - Phone:321-830-5033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty