Organization
BODY RX ANTIAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN SEVILLA (OWNER)
(786) 899-4514
Entity
Organization
Contact information
Practice address
10261 SW 72ND ST, SUITE C105, MIAMI, FL 33173-3023
(786) 899-4514
(786) 245-6701
Mailing address
10261 SW 72ND ST, SUITE C105, MIAMI, FL 33173-3023
(786) 899-4514
(786) 245-6701
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
08/23/2013
Last updated
08/23/2013
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