Provider Demographics
NPI:1093087215
Name:UNIVERSAL AESTHETIC SOLUTIONS
Entity type:Organization
Organization Name:UNIVERSAL AESTHETIC SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKULINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-553-3364
Mailing Address - Street 1:260 95 STREET
Mailing Address - Street 2:SURFSIDE PAIN CONTROL CENTER
Mailing Address - City:SURFSIDE
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2807
Mailing Address - Country:US
Mailing Address - Phone:305-861-0078
Mailing Address - Fax:305-993-3838
Practice Address - Street 1:260 95 STREET
Practice Address - Street 2:SURFSIDE PAIN CONTROL CENTER
Practice Address - City:SURFSIDE
Practice Address - State:FL
Practice Address - Zip Code:33154-2807
Practice Address - Country:US
Practice Address - Phone:305-861-0078
Practice Address - Fax:305-993-3838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74241207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH01707Medicare UPIN