Organization Name: | SOUTH FLORIDA INSTITUTE FOR LASER VAGINAL REJUVENATION, INC |
NPI Number: | 1669630257 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RAFAEL ANTUN (PRESIDENT) |
Mailing Address: | 7600 Sw 57th Ave Suite 201 South Miami |
State: | FL US |
Postal Code: | 331435428 |
Phone Number: | 3056682853 |
Fax Number: | 3056752474 |
NPI Enumeration Date: | 05/30/2008 |
NPI Last Update Date: | 05/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME59386 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |