Provider Demographics
NPI:1992262059
Name:CLEARWATER ACUPUNCTURE, LLC
Entity type:Organization
Organization Name:CLEARWATER ACUPUNCTURE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:TAMBURRINO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:727-351-2882
Mailing Address - Street 1:26133 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 218
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763
Mailing Address - Country:US
Mailing Address - Phone:727-351-2882
Mailing Address - Fax:727-222-3540
Practice Address - Street 1:26133 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 218
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763
Practice Address - Country:US
Practice Address - Phone:727-351-2882
Practice Address - Fax:727-222-3540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2023-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty