Provider Demographics
NPI:1306119805
Name:PERFECT UNION OF BODY & MIND, INC.
Entity type:Organization
Organization Name:PERFECT UNION OF BODY & MIND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PD
Authorized Official - Prefix:DR
Authorized Official - First Name:YAN PING
Authorized Official - Middle Name:
Authorized Official - Last Name:XU
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, AP
Authorized Official - Phone:561-241-1922
Mailing Address - Street 1:7781 NW BEACON SQUARE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1313
Mailing Address - Country:US
Mailing Address - Phone:561-241-1922
Mailing Address - Fax:561-241-1979
Practice Address - Street 1:7781 NW BEACON SQUARE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1313
Practice Address - Country:US
Practice Address - Phone:561-241-1922
Practice Address - Fax:561-241-1979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171100000X385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1437324175OtherACUPUNCTURIST