Healthcare Provider Details

I. General information

NPI: 1538082110
Provider Name (Legal Business Name): GLOW BY BET MEDSPA & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 FONTAINEBLEAU BLVD STE 2K2
MIAMI FL
33172-7014
US

IV. Provider business mailing address

175 FONTAINEBLEAU BLVD STE 2K2
MIAMI FL
33172-7014
US

V. Phone/Fax

Practice location:
  • Phone: 786-280-6324
  • Fax:
Mailing address:
  • Phone: 786-280-6324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BETZY MEDERO MILLAR
Title or Position: OWNER
Credential: APRN
Phone: 786-255-0461