Healthcare Provider Details

I. General information

NPI: 1568609725
Provider Name (Legal Business Name): CUERPOS, SALUD Y BELLEZA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2009
Last Update Date: 01/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 N UNIVERSITY DR STE 502
SUNRISE FL
33351-6320
US

IV. Provider business mailing address

3801 N UNIVERSITY DR STE 502
SUNRISE FL
33351-6320
US

V. Phone/Fax

Practice location:
  • Phone: 954-749-3339
  • Fax: 954-749-3370
Mailing address:
  • Phone: 954-749-3339
  • Fax: 954-749-3370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: GLORIA DUARTE
Title or Position: PRESIDENT
Credential:
Phone: 954-749-3339