# MIA ESTHETICS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** florida performance inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992970784
- **Authorized official:** MADELAINE IZQUIERDO P.A. (DIRECTOR)
- **Authorized official phone:** (305) 828-7111

## Contact information

- **Practice address:** 7660A NW 186TH ST, HIALEAH, FL 33015-2925
- **Practice address phone:** (305) 828-7111
- **Mailing address:** 7660-A N.W. 186TH STREET, MIAMI, FL 33015
- **Mailing address phone:** (305) 828-7111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | ME93952 | FL | Yes |

## Other

- **Enumeration date:** 04/23/2008
- **Last updated:** 04/23/2008