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General NPI Number Information
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NPI Number | 1386709780
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Entity Type | Organization
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Legal Business Name | ZEN VIDA MEDICAL SPA, LLC
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10773 NW 58TH ST STE 213
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City | DORAL
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State | FL
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Zip | 33178-2801
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Country | US
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Telephone | 305-594-7632
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Fax | 954-255-9631
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Provider Business Mailing Address
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Address Line | 10773 NW 58TH ST STE 213
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City | DORAL
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State | FL
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Zip | 33178-2801
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Country | US
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Telephone | 305-594-7632
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Fax | 954-255-9631
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA DEL C BELTRAN
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Credential |
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Telephone | 305-594-7632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME42709
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License Number State | FL
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