# MIRACLE ANGELS MED SPA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457024994
- **Authorized official:** YAMILKA POUJAUD RODRIGUEZ APRN (OWNER)
- **Authorized official phone:** (305) 281-2494

## Contact information

- **Practice address:** 14201 SW 120TH ST STE 205, MIAMI, FL 33186-7663
- **Practice address phone:** (305) 281-2494
- **Practice address fax:** (305) 675-5960
- **Mailing address:** 14201 SW 120TH ST STE 205, MIAMI, FL 33186-7663
- **Mailing address phone:** (305) 281-2494
- **Mailing address fax:** (305) 675-5960

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/30/2021
- **Last updated:** 08/02/2021