Healthcare Provider Details

I. General information

NPI: 1760143358
Provider Name (Legal Business Name): ACUPUNCTUREOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2022
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19790 W DIXIE HWY STE 1208
MIAMI FL
33180-2548
US

IV. Provider business mailing address

19212 NE 25TH AVE APT 282
MIAMI FL
33180-3218
US

V. Phone/Fax

Practice location:
  • Phone: 305-725-1152
  • Fax:
Mailing address:
  • Phone: 305-725-1152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID NEVINS
Title or Position: OWNER ACUPUNCTURIST
Credential: AP
Phone: 305-725-1152