Healthcare Provider Details

I. General information

NPI: 1518564996
Provider Name (Legal Business Name): ADA KNECHT DOM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2020
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 GIRALDA AVE
CORAL GABLES FL
33134-5208
US

IV. Provider business mailing address

14075 SW 72ND CT
PALMETTO BAY FL
33158-1263
US

V. Phone/Fax

Practice location:
  • Phone: 305-567-1973
  • Fax:
Mailing address:
  • Phone: 305-342-0076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. ADA KNECHT
Title or Position: MANAGING DIRECTOR
Credential: DOM
Phone: 305-342-0076