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Organization

BODHI TRADITIONAL CHINESE MEDICINE INC

Active
Other names
Bodhi TCM
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANDREA IZQUIERDO LAC, DOM (DR. OF CHINESE MEDICINE)
(321) 312-0771
Entity
Organization

Contact information

Practice address
304 S HARBOR CITY BLVD STE 101, MELBOURNE, FL 32901-1382
(321) 312-0771
(352) 204-8490
Mailing address
304 S HARBOR CITY BLVD STE 101, MELBOURNE, FL 32901-1382
(321) 312-0771
(352) 204-8490

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP3822
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1972031169
PERSONAL NPI
Enumeration date
06/22/2017
Last updated
01/13/2026
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