# GULF COAST ACUPUNCTURE & WELLNESS CLINIC, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366649469
- **Authorized official:** DR. MATT R DEBONA (ACUPUNCTURE PHYSICIAN)
- **Authorized official phone:** (941) 473-8978

## Contact information

- **Practice address:** 642 N INDIANA AVE, ENGLEWOOD, FL 34223-2728
- **Practice address phone:** (941) 473-8978
- **Mailing address:** 642 N INDIANA AVE, ENGLEWOOD, FL 34223-2728

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AP1555 | FL | Yes |

## Other

- **Enumeration date:** 07/02/2007
- **Last updated:** 08/22/2020