Healthcare Provider Details

I. General information

NPI: 1619247566
Provider Name (Legal Business Name): RISING ACUPUNCTURE LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2012
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 W 41ST ST SUITE 211
MIAMI BEACH FL
33140-3329
US

IV. Provider business mailing address

975 W 41ST ST SUITE 211
MIAMI BEACH FL
33140-3329
US

V. Phone/Fax

Practice location:
  • Phone: 305-532-0777
  • Fax: 305-532-0888
Mailing address:
  • Phone: 305-532-0777
  • Fax: 305-532-0888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JEFFREY A. PROL
Title or Position: ACUPUNCTURE PHYSICIAN
Credential:
Phone: 305-532-0777