Provider Demographics
NPI:1225884232
Name:MEDMAX ACUPUNCTURE LLC
Entity type:Organization
Organization Name:MEDMAX ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:LARA-CORMIER
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:954-588-7999
Mailing Address - Street 1:5197 SW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-3272
Mailing Address - Country:US
Mailing Address - Phone:786-907-5827
Mailing Address - Fax:954-272-7179
Practice Address - Street 1:12781 MIRAMAR PKWY STE 206
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2908
Practice Address - Country:US
Practice Address - Phone:786-907-5827
Practice Address - Fax:954-272-7179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty