Organization
MIRACLE ANGELS MED SPA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAMILKA POUJAUD RODRIGUEZ APRN (OWNER)
(305) 281-2494
Entity
Organization
Contact information
Practice address
14201 SW 120TH ST STE 205, MIAMI, FL 33186-7663
(305) 281-2494
(305) 675-5960
Mailing address
14201 SW 120TH ST STE 205, MIAMI, FL 33186-7663
(305) 281-2494
(305) 675-5960
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/30/2021
Last updated
08/02/2021
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