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Organization
DERMA BEAUTY SPA MEDICAL CLINIC
Active
Organization
DERMA BEAUTY SPA MEDICAL CLINIC
Active
Other names
Derma Beauty spa Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCIE MEDINA (OWNER)
(786) 454-6630
Entity
Organization
Contact information
Practice address
1470 NW 107TH AVE STE M, SWEETWATER, FL 33172-2735
(305) 594-5999
Mailing address
1470 NW 107TH AVE STE M, SWEETWATER, FL 33172-2735
(305) 594-5999
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
NULL
Other
Enumeration date
09/10/2020
Last updated
10/16/2020
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