Healthcare Provider Details

I. General information

NPI: 1144195074
Provider Name (Legal Business Name): ROSE BELLA MED SPA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13155 SW 134TH ST STE 106
MIAMI FL
33186-4487
US

IV. Provider business mailing address

13155 SW 134TH ST STE 106
MIAMI FL
33186-4487
US

V. Phone/Fax

Practice location:
  • Phone: 305-972-5669
  • Fax: 305-847-2812
Mailing address:
  • Phone: 305-972-5669
  • Fax: 305-847-2812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LAURA E AMORES POMARES
Title or Position: OWNER
Credential:
Phone: 305-281-8339