=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598634313
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE BAR AESTHETICS & WELLNESS, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/31/2025
-----------------------------------------------------
Last Update Date | 10/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3564 E COLONIAL DR STE 17
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32803-5147
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-765-2289
-----------------------------------------------------
Fax | 321-300-1061
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 905 LITTLE CREEK RD
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32825-7308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-765-2289
-----------------------------------------------------
Fax | 321-300-1061
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. ELENA VALE-SAQUIERES
-----------------------------------------------------
Credential | FNP-C
-----------------------------------------------------
Telephone | 407-765-2289
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------