Provider Demographics
NPI:1457579997
Name:A SUPER HEALTH CARE CENTER,INC.
Entity Type:Organization
Organization Name:A SUPER HEALTH CARE CENTER,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAN MING
Authorized Official - Middle Name:
Authorized Official - Last Name:DU
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:561-381-3303
Mailing Address - Street 1:15300 JOG RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2162
Mailing Address - Country:US
Mailing Address - Phone:561-381-3303
Mailing Address - Fax:954-753-6681
Practice Address - Street 1:15300 JOG RD
Practice Address - Street 2:SUITE 209
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2162
Practice Address - Country:US
Practice Address - Phone:561-381-3303
Practice Address - Fax:954-753-6681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP0000968171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9053874OtherPHCS AND MULTI PLAN
CA2215979350301OtherBEECH STREET