Provider Demographics
NPI:1851147359
Name:EGAN AESTHETICS LLC
Entity type:Organization
Organization Name:EGAN AESTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ELECTROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-720-9880
Mailing Address - Street 1:1954 US HIGHWAY 1 STE 113
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3761
Mailing Address - Country:US
Mailing Address - Phone:321-720-9880
Mailing Address - Fax:
Practice Address - Street 1:1954 US HIGHWAY 1 STE 113
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3761
Practice Address - Country:US
Practice Address - Phone:321-720-9880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationGroup - Single Specialty