Healthcare Provider Details

I. General information

NPI: 1497688501
Provider Name (Legal Business Name): ACUPUNCTURE HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

5709 SW 118TH AVE
MIAMI FL
33183-1721
US

IV. Provider business mailing address

5709 SW 118TH AVE
MIAMI FL
33183-1721
US

V. Phone/Fax

Practice location:
  • Phone: 305-389-0824
  • Fax:
Mailing address:
  • Phone: 305-389-0824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PHANESSA PEREZ
Title or Position: MGR
Credential: AP
Phone: 305-389-0824