Provider Demographics
NPI:1902175904
Name:SERENE LIFE ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:SERENE LIFE ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:XIANHUI
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, AP
Authorized Official - Phone:786-925-8098
Mailing Address - Street 1:12616 SW 122ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5465
Mailing Address - Country:US
Mailing Address - Phone:786-925-8098
Mailing Address - Fax:
Practice Address - Street 1:9420 SW 77TH AVE # 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2501
Practice Address - Country:US
Practice Address - Phone:786-925-8098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2612171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty