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General NPI Number Information
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NPI Number | 1356911770
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Entity Type | Organization
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Legal Business Name | BELFON HEALTH AND AESTHETICS
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 12064 MIRAMAR PKWY STE 101
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City | MIRAMAR
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State | FL
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Zip | 33025-7003
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Country | US
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Telephone | 786-412-1150
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Fax |
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Provider Business Mailing Address
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Address Line | 1861 SW 101ST WAY
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City | MIRAMAR
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State | FL
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Zip | 33025-6531
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Country | US
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Telephone | 786-412-1150
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Fax | 478-202-9585
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Authorized Official
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Title or Position | OWNER, NURSE PRACTITIONER
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Name | MRS. TYSHARRA KENYATTA BELFON
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Credential | NP
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Telephone | 786-412-1150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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