MEDICARE: DRIP & GLOW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1821844804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRIP & GLOW

Provider Business Mailing Address
First Line	:	1480 NW NORTH RIVER DR APT 304
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-2868
Country	:	US
Telephone Number	:	315-745-0904
Fax Number	:

Provider Business Practice Location Address
First Line	:	1480 NW NORTH RIVER DR APT 304
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-2868
Country	:	US
Telephone Number	:	315-745-0904
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	AISHA ABDEL-MOTELB
Credential	:	NP
Telephone Number	:	315-745-0904

Provider Enumeration Date	:	04/29/2024
Last Update Date	:	04/29/2024

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Directions to “DRIP & GLOW ” Practice Location

Language	Start Address	Practice Location

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