Organization
RENAISSANCE MEDICAL AESTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISSETTE I GUZMAN (OWNER)
(860) 912-8738
Entity
Organization
Contact information
Practice address
11 SANDERSDALE RD # 15, SOUTHBRIDGE, MA 01550-2855
(774) 371-4180
Mailing address
11 SANDERSDALE RD # 15, SOUTHBRIDGE, MA 01550-2855
(774) 371-4180
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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