Provider Demographics
NPI:1205008745
Name:NU INSTITUTE FOR AGE MANAGMENT
Entity Type:Organization
Organization Name:NU INSTITUTE FOR AGE MANAGMENT
Other - Org Name:MIAMI INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-624-0009
Mailing Address - Street 1:1441 BRICKELL AVE
Mailing Address - Street 2:3RD FLOOR SKY LOBBY
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3439
Mailing Address - Country:US
Mailing Address - Phone:305-625-0009
Mailing Address - Fax:305-373-1175
Practice Address - Street 1:1441 BRICKELL AVE
Practice Address - Street 2:3RD FLOOR SKY LOBBY
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-3439
Practice Address - Country:US
Practice Address - Phone:305-625-0009
Practice Address - Fax:305-373-1175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty