MEDICARE: ESSENTIAL AESTHETICS & HEALTH, LLC

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

General Provider Information

NPI Number	:	1952292625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSENTIAL AESTHETICS & HEALTH, LLC

Provider Business Mailing Address
First Line	:	6801 NW 46TH CT
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33319-4024
Country	:	US
Telephone Number	:	954-628-6807
Fax Number	:

Provider Business Practice Location Address
First Line	:	1975 E SUNRISE BLVD STE 615
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-1453
Country	:	US
Telephone Number	:	754-778-7375
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ESHA LESTRADE
Credential	:
Telephone Number	:	547-778-7375

Provider Enumeration Date	:	07/11/2025
Last Update Date	:	07/11/2025

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