Healthcare Provider Details

I. General information

NPI: 1467214874
Provider Name (Legal Business Name): CENTURY AESTHETICS & RESEARCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7481 BIRD RD
MIAMI FL
33155-6635
US

IV. Provider business mailing address

7481 BIRD RD
MIAMI FL
33155-6635
US

V. Phone/Fax

Practice location:
  • Phone: 305-342-2481
  • Fax:
Mailing address:
  • Phone: 305-342-2481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALIETTE NEYRA
Title or Position: MGR
Credential: NP
Phone: 305-342-2481