Individual
MRS. ANDREA GAIL SPADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MEDICAL AESTHETICIAN
Contact information
Practice address
1606 NE MIAMI GARDENS DR, N MIAMI BEACH, FL 33179-4900
(305) 354-8266
(305) 354-8280
Mailing address
1606 NE MIAMI GARDENS DR, N MIAMI BEACH, FL 33179-4900
(305) 354-8266
(305) 354-8280
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
FB93013
FL
174400000X
Specialist
Primary
FB9722504
FL
174400000X
Specialist
MA50604
FL
174400000X
Specialist
MA60818
FL
247200000X
Other Technician
EO1620
FL
Other
Enumeration date
12/20/2010
Last updated
03/22/2012
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