Organization
FOREVER YOUNG COSMETICS & SURGERY CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTO FALCON (PRESIDENT)
(786) 374-5868
Entity
Organization
Contact information
Practice address
1790 SW 27TH AVE, MIAMI, FL 33145-2418
(305) 444-4274
(305) 444-4374
Mailing address
1790 SW 27TH AVE, MIAMI, FL 33145-2418
(305) 444-4274
(305) 444-4374
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OSR987
FL
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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