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General NPI Number Information
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NPI Number | 1730053240
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Entity Type | Organization
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Legal Business Name | ESSENCE MED SPA AND WELLNESS CENTER INC.
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 20335 BISCAYNE BLVD # L10-11
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City | AVENTURA
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State | FL
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Zip | 33180-1503
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Country | US
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Telephone | --
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Fax |
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Provider Business Mailing Address
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Address Line | 20335 BISCAYNE BLVD # L10-11
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City | AVENTURA
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State | FL
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Zip | 33180-1503
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CORP. SECRETARY
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Name | INNA PROSHAK
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Credential |
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Telephone | --
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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