Healthcare Provider Details

I. General information

NPI: 1922926559
Provider Name (Legal Business Name): XU LEGACY ACUPUNCTURE CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9555 N KENDALL DR STE 101
MIAMI FL
33176-1978
US

IV. Provider business mailing address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

V. Phone/Fax

Practice location:
  • Phone: 786-897-4738
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ADA XU
Title or Position: OWNER, ACUPUNCTURE PHYSICIAN
Credential: L.AC./A.P.
Phone: 786-897-4631