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NPI Code Detail

MEDICARE: NEW COSMETIC CENTER CORP

MEDICARE: NEW COSMETIC CENTER CORP
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
1261Q00000XClinic/Center600835-3FL

General Provider Information

NPI Number : 1306899547
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW COSMETIC CENTER CORP
Provider Business Mailing Address
First Line : 1051 W 29TH ST
Second Line : SUITE 3
City : HIALEAH
State : FL
Zip : 33012-5057
Country : US
Telephone Number : 786-718-3156
Fax Number : 305-858-3156
Provider Business Practice Location Address
First Line : 1051 W 29TH ST
Second Line : SUITE 3
City : HIALEAH
State : FL
Zip : 33012-5057
Country : US
Telephone Number : 786-718-3156
Fax Number : 305-858-3156
Authorized Official
Title or Position : PRESIDENT
Name : ORGE BERMEJO
Credential :
Telephone Number : 786-718-3156
Provider Enumeration Date : 05/18/2006
Last Update Date : 08/22/2020

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Directions to “NEW COSMETIC CENTER CORP ” Practice Location

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