Healthcare Provider Details

I. General information

NPI: 1902477730
Provider Name (Legal Business Name): SKY COSMETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2021
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 SW 38TH AVE STE 800
MIAMI FL
33146-1530
US

IV. Provider business mailing address

3150 SW 38TH AVE STE 800
MIAMI FL
33146-1530
US

V. Phone/Fax

Practice location:
  • Phone: 786-409-4135
  • Fax: 786-472-7026
Mailing address:
  • Phone: 786-409-4135
  • Fax: 786-472-7026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAIME I FLORES
Title or Position: CEO
Credential: MD
Phone: 786-409-4135