Provider Demographics
NPI:1003251257
Name:MIAMI BEACH PLASTIC SURGERY CENTER AND MEDSPA, LLC
Entity Type:Organization
Organization Name:MIAMI BEACH PLASTIC SURGERY CENTER AND MEDSPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:TACHMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-531-9800
Mailing Address - Street 1:1674 MERIDIAN AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-2801
Mailing Address - Country:US
Mailing Address - Phone:305-531-9800
Mailing Address - Fax:305-531-9801
Practice Address - Street 1:1674 MERIDIAN AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-2801
Practice Address - Country:US
Practice Address - Phone:305-531-9800
Practice Address - Fax:305-531-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65509208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty