Provider Demographics
NPI:1538034129
Name:LUXE DERM SPA
Entity type:Organization
Organization Name:LUXE DERM SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TUNISIA
Authorized Official - Middle Name:FINCH
Authorized Official - Last Name:CORNELIUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-607-9923
Mailing Address - Street 1:830 GLENWOOD AVE SE STE 510-209
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-1966
Mailing Address - Country:US
Mailing Address - Phone:404-354-0101
Mailing Address - Fax:678-589-7500
Practice Address - Street 1:1323 METROPOLITAN PKWY SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-4441
Practice Address - Country:US
Practice Address - Phone:678-607-9923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty