Organization
DESTINY MED SPA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDNA VIVIANA AYALA (OWNER)
(786) 444-6589
Entity
Organization
Contact information
Practice address
5636 NW 167TH ST, MIAMI LAKES, FL 33014-6135
(305) 800-5476
Mailing address
5636 NW 167TH ST, MIAMI LAKES, FL 33014-6135
(305) 800-5476
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/01/2026
Last updated
08/03/2026
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