Provider Demographics
NPI:1780049007
Name:SHEN MING CO
Entity type:Organization
Organization Name:SHEN MING CO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:DEBORAH
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:305-981-7958
Mailing Address - Street 1:2134 NE 123RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2902
Mailing Address - Country:US
Mailing Address - Phone:305-981-7958
Mailing Address - Fax:305-981-7961
Practice Address - Street 1:2134 NE 123RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2902
Practice Address - Country:US
Practice Address - Phone:305-981-7958
Practice Address - Fax:305-981-7961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL891171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1861517716OtherINDIVIDUAL NPI