Organization
BODY THERAPY WELLNESS & AESTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN LAMADRID (ADMINISTRATOR)
(813) 453-6179
Entity
Organization
Contact information
Practice address
4422 5TH ST W, BRADENTON, FL 34207-1531
(941) 222-1808
(941) 240-1755
Mailing address
4422 5TH ST W, BRADENTON, FL 34207-1531
(941) 222-1808
(941) 240-1755
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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