Organization
MIA ESTHETICS
Active
Other names
florida performance inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MADELAINE IZQUIERDO P.A. (DIRECTOR)
(305) 828-7111
Entity
Organization
Contact information
Practice address
7660A NW 186TH ST, HIALEAH, FL 33015-2925
(305) 828-7111
Mailing address
7660-A N.W. 186TH STREET, MIAMI, FL 33015
(305) 828-7111
Taxonomy
Speciality
Code
Description
License number
State
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
Primary
ME93952
FL
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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