Provider Demographics
NPI:1174981112
Name:AURA AND EARTH HEALING APOTHECARY LLC
Entity type:Organization
Organization Name:AURA AND EARTH HEALING APOTHECARY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA LMT CELEBRANT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LA COA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-306-7948
Mailing Address - Street 1:636 SW 33RD AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2631
Mailing Address - Country:US
Mailing Address - Phone:786-306-7948
Mailing Address - Fax:
Practice Address - Street 1:636 SW 33RD AVE
Practice Address - Street 2:APT 1
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2631
Practice Address - Country:US
Practice Address - Phone:786-306-7948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA46147173C00000X, 225700000X
FL374K00000X, 374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty
No173C00000XOther Service ProvidersReflexologistGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Single Specialty