Healthcare Provider Details

I. General information

NPI: 1144148438
Provider Name (Legal Business Name): KETAMINE HAUS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 S LE JEUNE RD
CORAL GABLES FL
33146-2231
US

IV. Provider business mailing address

4950 S LE JEUNE RD
CORAL GABLES FL
33146-2231
US

V. Phone/Fax

Practice location:
  • Phone: 305-335-5745
  • Fax:
Mailing address:
  • Phone: 305-335-5745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LUCIANA M PATSIGA
Title or Position: MANAGER
Credential: MD
Phone: 786-525-9722