Organization
AGELESS BODY BY NEW SCIENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO PRESAS MEDICAL DOCTOR (DIRECTOR)
(954) 990-0302
Entity
Organization
Contact information
Practice address
2500 E HALLANDALE BEACH BLVD STE 406, HALLANDALE BEACH, FL 33009-4837
(954) 990-0302
(954) 908-7101
Mailing address
2500 E HALLANDALE BEACH BLVD STE 406, HALLANDALE BEACH, FL 33009-4837
(954) 990-0302
(954) 755-9347
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
CH 11660
FL
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760841472
MEDICAL OFFICE
FL
05
—
1760841472
—
FL
Enumeration date
02/23/2016
Last updated
03/27/2019
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