Provider Demographics
NPI:1255225298
Name:AESTHETIC EXPRESS LLC
Entity type:Organization
Organization Name:AESTHETIC EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ZAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTERO RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:AG-ACNP/FNP/APRN
Authorized Official - Phone:786-416-4405
Mailing Address - Street 1:19831 SW 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-2017
Mailing Address - Country:US
Mailing Address - Phone:786-416-4405
Mailing Address - Fax:
Practice Address - Street 1:9160 NW 122ND ST UNIT 19
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-2083
Practice Address - Country:US
Practice Address - Phone:786-416-4405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-04
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center