# SECRETS AESTHETICS AND WELLNESS CENTER, LLC

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

## Provider details

- **NPI number:** 1841051752
- **Authorized official:** JOHN DISTEFANO (BUSINESS MANAGER)
- **Authorized official phone:** (352) 317-3214

## Contact information

- **Practice address:** 7601 WINDERMERE CONROY RD STE 202, ORLANDO, FL 32835-2688
- **Practice address phone:** (407) 775-2845
- **Mailing address:** 7601 WINDERMERE CONROY RD STE 202, ORLANDO, FL 32835-2688

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/17/2024
- **Last updated:** 03/18/2024