Provider Demographics
NPI:1235829326
Name:LYF AESTHETICS
Entity Type:Organization
Organization Name:LYF AESTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:CEPERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-300-8788
Mailing Address - Street 1:14707 S DIXIE HWY STE 403
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7954
Mailing Address - Country:US
Mailing Address - Phone:305-614-2088
Mailing Address - Fax:
Practice Address - Street 1:14707 S DIXIE HWY STE 403
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33176-7954
Practice Address - Country:US
Practice Address - Phone:305-614-2088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty