Healthcare Provider Details

I. General information

NPI: 1003251257
Provider Name (Legal Business Name): MIAMI BEACH PLASTIC SURGERY CENTER AND MEDSPA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 05/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1674 MERIDIAN AVE SUITE 204
MIAMI BEACH FL
33139-2801
US

IV. Provider business mailing address

1674 MERIDIAN AVE SUITE 204
MIAMI BEACH FL
33139-2801
US

V. Phone/Fax

Practice location:
  • Phone: 305-531-9800
  • Fax: 305-531-9801
Mailing address:
  • Phone: 305-531-9800
  • Fax: 305-531-9801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME65509
License Number StateFL

VIII. Authorized Official

Name: DR. LEONARD TACHMES
Title or Position: OWNER
Credential: M.D.
Phone: 305-531-9800