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General NPI Number Information
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NPI Number | 1639091234
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Entity Type | Organization
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Legal Business Name | DERMALUXE CLINIC CORP
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 13200 SW 128TH ST STE D4
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City | MIAMI
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State | FL
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Zip | 33186-5829
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Country | US
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Telephone | 305-994-6419
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Fax |
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Provider Business Mailing Address
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Address Line | 13200 SW 128TH ST STE D4
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City | MIAMI
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State | FL
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Zip | 33186-5829
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Country | US
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Telephone | 305-994-6419
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YENISSET GAZQUEZ PENALVER
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Credential | RN
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Telephone | 305-994-6419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number |
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License Number State |
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