Provider Demographics
NPI:1932560331
Name:BEYOND THE NEEDLE
Entity Type:Organization
Organization Name:BEYOND THE NEEDLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KYMBERLY
Authorized Official - Middle Name:BLACK
Authorized Official - Last Name:CAPORALE
Authorized Official - Suffix:
Authorized Official - Credentials:AP DOM
Authorized Official - Phone:727-521-0210
Mailing Address - Street 1:111 SECOND AVE NE # 511
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3434
Mailing Address - Country:US
Mailing Address - Phone:727-521-0210
Mailing Address - Fax:727-521-0211
Practice Address - Street 1:111 2ND AVE NE STE 511
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3463
Practice Address - Country:US
Practice Address - Phone:727-521-0210
Practice Address - Fax:727-521-0211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 1348171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP1348OtherLICENSE #