Provider Demographics
NPI:1861156135
Name:ACUPUNCTURE AND HOLISTIC WELLNESS CENTER, INC
Entity type:Organization
Organization Name:ACUPUNCTURE AND HOLISTIC WELLNESS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:G
Authorized Official - Last Name:MARINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-873-2573
Mailing Address - Street 1:9127 WHISTABLE WALK
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-4172
Mailing Address - Country:US
Mailing Address - Phone:786-873-2573
Mailing Address - Fax:
Practice Address - Street 1:6447 MIAMI LAKES DR STE 210F
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2765
Practice Address - Country:US
Practice Address - Phone:786-873-2573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-23
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty