Provider Demographics
NPI:1427501790
Name:TRINITY ACUPUNCTURE, INC.
Entity type:Organization
Organization Name:TRINITY ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPES
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:512-534-9769
Mailing Address - Street 1:3455 NE 12TH TER STE 3
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-4560
Mailing Address - Country:US
Mailing Address - Phone:954-951-5982
Mailing Address - Fax:
Practice Address - Street 1:3455 NE 12TH TER STE 3
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-4560
Practice Address - Country:US
Practice Address - Phone:954-951-5982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3381171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty