Healthcare Provider Details

I. General information

NPI: 1609712322
Provider Name (Legal Business Name): SKIN HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2026
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 SW 39TH ST
CAPE CORAL FL
33914-5520
US

IV. Provider business mailing address

1811 SW 39TH ST
CAPE CORAL FL
33914-5520
US

V. Phone/Fax

Practice location:
  • Phone: 305-333-8982
  • Fax:
Mailing address:
  • Phone: 305-333-8982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MAGDA RIVAS
Title or Position: CEO/NURSE PRACTITIONER
Credential: APRN
Phone: 305-333-8982