# BEAUTY AND WELLNESS MED SPA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FD INTEGRATIVE CLINIC
- **Other names:** FD INTEGRATIVE CLINIC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1376024851
- **Legal business name:** FD INTEGRATIVE CLINIC
- **Authorized official:** FREDDY DUQUE ACUPUNCTURE PHYSICIA (ACUPUNCTURIST)
- **Authorized official phone:** (786) 547-2091

## Contact information

- **Practice address:** 1470 NW 107TH AVE STE A, SWEETWATER, FL 33172-2734
- **Practice address phone:** (786) 547-2091
- **Mailing address:** 7044 NW 113TH PL, DORAL, FL 33178-4542

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AP-3765 | FL | Yes |

## Other

- **Enumeration date:** 08/23/2018
- **Last updated:** 08/23/2018