Organization
ESENCIA PRIMARY CARE AND MEDSPA CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESUS RAMOS APRN (AUTHORIZED OFFICIAL)
(786) 615-5058
Entity
Organization
Contact information
Practice address
10520 NW 26TH ST STE C201, DORAL, FL 33172-2161
(786) 615-5558
Mailing address
10520 NW 26TH ST STE C201, DORAL, FL 33172-2161
(786) 615-5558
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11017780
LICENSE
FL
Enumeration date
05/17/2022
Last updated
05/17/2022
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