MEDICARE: LUXE AESTHETIC STUDIO INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1134953748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUXE AESTHETIC STUDIO INC

Provider Business Mailing Address
First Line	:	3390 BANKS RD APT 204
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-6953
Country	:	US
Telephone Number	:	954-868-0044
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 N FEDERAL HWY
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33308-5528
Country	:	US
Telephone Number	:	786-748-5745
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HEIDI SANCHEZ RAMBAY
Credential	:
Telephone Number	:	786-748-5745

Provider Enumeration Date	:	08/27/2024
Last Update Date	:	10/03/2024

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