Organization
GENX MEDICAL SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA CARRASCO (PRESIDENT)
(786) 797-3187
Entity
Organization
Contact information
Practice address
823 S UNIVERSITY DR # C-94, PLANTATION, FL 33324-3317
(954) 993-6847
Mailing address
2115 NE 198TH TER, MIAMI, FL 33179-3133
(954) 993-6847
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/27/2015
Last updated
02/27/2015
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