Provider Demographics
NPI:1225780265
Name:MED RESEARCH AND AESTHETICS LLC
Entity Type:Organization
Organization Name:MED RESEARCH AND AESTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:I
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-680-4848
Mailing Address - Street 1:8040 NW 95TH ST STE 339
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2361
Mailing Address - Country:US
Mailing Address - Phone:305-680-4848
Mailing Address - Fax:
Practice Address - Street 1:8040 NW 95TH ST STE 339
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-2361
Practice Address - Country:US
Practice Address - Phone:305-680-4848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch