Provider Demographics
NPI:1992970743
Name:MERIDIAN ACUPUNCTURE CENTER INC
Entity type:Organization
Organization Name:MERIDIAN ACUPUNCTURE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:BOOKER
Authorized Official - Suffix:
Authorized Official - Credentials:AP/DOM
Authorized Official - Phone:352-458-9234
Mailing Address - Street 1:14022 5TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33525-4323
Mailing Address - Country:US
Mailing Address - Phone:352-458-9234
Mailing Address - Fax:352-518-4627
Practice Address - Street 1:14022 5TH ST STE B
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-4323
Practice Address - Country:US
Practice Address - Phone:352-458-9234
Practice Address - Fax:352-518-4627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0738171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty