Provider Demographics
NPI:1144707068
Name:ALTERNATIVE MEDICINE ACUPUNCTURE
Entity type:Organization
Organization Name:ALTERNATIVE MEDICINE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IVAYLO
Authorized Official - Middle Name:
Authorized Official - Last Name:GUEORGUIEV
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, AP
Authorized Official - Phone:813-444-2020
Mailing Address - Street 1:PO BOX 152592
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33684-2592
Mailing Address - Country:US
Mailing Address - Phone:813-444-2020
Mailing Address - Fax:
Practice Address - Street 1:2605 W SWANN AVE STE 600
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609
Practice Address - Country:US
Practice Address - Phone:813-444-2020
Practice Address - Fax:813-877-1277
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTERNATIVE MEDICINE ACUPUNCTURE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-24
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3960261QH0100X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty