MEDICARE: BRICKELLASHES 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
2	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1942168828
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRICKELLASHES INC

Provider Business Mailing Address
First Line	:	175 SW 7TH ST STE 1209
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-2952
Country	:	US
Telephone Number	:	305-504-4517
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 SW 7TH ST STE 1209
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-2952
Country	:	US
Telephone Number	:	305-504-4517
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ROSAINE QUINTANA
Credential	:
Telephone Number	:	305-504-4517

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “BRICKELLASHES INC ” Practice Location

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