Healthcare Provider Details

I. General information

NPI: 1346798162
Provider Name (Legal Business Name): LMC HEALTH & ESTHETIC CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2016
Last Update Date: 07/21/2022
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6850 CORAL WAY STE 502
MIAMI FL
33155-1758
US

IV. Provider business mailing address

6850 CORAL WAY STE 502
MIAMI FL
33155-1758
US

V. Phone/Fax

Practice location:
  • Phone: 786-241-6286
  • Fax:
Mailing address:
  • Phone: 786-241-6286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: ROSA CAMPILLO
Title or Position: ADMINISTRATOR
Credential:
Phone: 786-241-6286