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General NPI Number Information
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NPI Number | 1073700670
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Entity Type | Organization
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Legal Business Name | MIAMI AESTHETICS INC
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 9420 PARK DR
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2744
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Country | US
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Telephone | 305-756-7898
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Fax | 305-756-7898
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Provider Business Mailing Address
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Address Line | 9420 PARK DR
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2744
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Country | US
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Telephone | 305-756-7898
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Fax | 305-756-7898
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Authorized Official
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Title or Position | D.O.
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Name | MS. MARIA DIAZ
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Credential | DO PHARMD
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Telephone | 305-756-7899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS27564
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS8226
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License Number State | FL
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