Organization
ASCENSION WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ABRAHAM D.O.M. (CEO)
(813) 732-2108
Entity
Organization
Contact information
Practice address
11025 POND PINE DR, RIVERVIEW, FL 33569-2235
(813) 732-2108
Mailing address
11025 POND PINE DR, RIVERVIEW, FL 33569-2235
(813) 732-2108
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP2707
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
COOOE
BLUE CROSS/BLUE SHIELD PROVIDER NUMBER
FL
Enumeration date
09/25/2009
Last updated
05/19/2011
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