Healthcare Provider Details

I. General information

NPI: 1790020428
Provider Name (Legal Business Name): DG ESTHETIC AND THERAPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2012
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NW 35TH AVE STE 100
MIAMI FL
33125-4000
US

IV. Provider business mailing address

8370 W FLAGLER ST STE 252
MIAMI FL
33144-2040
US

V. Phone/Fax

Practice location:
  • Phone: 786-378-5800
  • Fax: 786-378-5801
Mailing address:
  • Phone: 786-378-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberHCC9765
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANIA LIMA
Title or Position: OWNER
Credential:
Phone: 786-378-5800