Organization Name: | VANITAS AESTHETIC LLC |
NPI Number: | 1518331727 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JANET RAMOS (OFFICE MANAGER) |
Mailing Address: | 9938 Universal Blvd Ste 102 Orlando |
State: | FL US |
Postal Code: | 328198705 |
Phone Number: | 4076155844 |
Fax Number: | 4079309232 |
NPI Enumeration Date: | 11/25/2015 |
NPI Last Update Date: | 11/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ACN572 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |