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General NPI Number Information
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NPI Number | 1558142703
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Entity Type | Organization
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Legal Business Name | BEAUTY BY DESIGN MEDSPA LLC
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 1 S ROYAL POINCIANA BLVD STE 102
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-6058
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Country | US
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Telephone | 305-450-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 1 S ROYAL POINCIANA BLVD STE 102
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-6058
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Country | US
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Telephone | 305-450-5577
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | GILDAYESSI FERNANDEZ
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Credential | NP
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Telephone | 786-860-7129
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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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