MEDICARE: BEAUTY AND WELLNESS MEDICAL CENTER 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	261Q00000X	Clinic/Center	ME88937	FL

General Provider Information

NPI Number	:	1306273800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEAUTY AND WELLNESS MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	8660 W FLAGLER ST STE 209
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2033
Country	:	US
Telephone Number	:	305-303-2917
Fax Number	:

Provider Business Practice Location Address
First Line	:	8660 W FLAGLER ST STE 209
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2033
Country	:	US
Telephone Number	:	305-303-2917
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	JUAN M HADDAD
Credential	:	MD
Telephone Number	:	305-303-2917

Provider Enumeration Date	:	09/30/2013
Last Update Date	:	09/30/2013

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