Provider Demographics
NPI:1104107598
Name:CUERPOS HEALTH & AESTHETIC, LLC
Entity type:Organization
Organization Name:CUERPOS HEALTH & AESTHETIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ALINA
Authorized Official - Last Name:JULIA
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:305-227-4077
Mailing Address - Street 1:8410 W FLAGLER ST STE 206B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2020
Mailing Address - Country:US
Mailing Address - Phone:305-227-4077
Mailing Address - Fax:305-227-4045
Practice Address - Street 1:8410 W FLAGLER ST STE 206B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2020
Practice Address - Country:US
Practice Address - Phone:305-227-4077
Practice Address - Fax:305-227-4045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA48285302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization