Provider Demographics
NPI:1497476071
Name:MIND BODY & SKIN BY JASMIN LLC
Entity Type:Organization
Organization Name:MIND BODY & SKIN BY JASMIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JASMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ACEVEDO-STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-648-3787
Mailing Address - Street 1:12360 66TH ST STE O
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-3434
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12360 66TH ST STE O
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-3434
Practice Address - Country:US
Practice Address - Phone:727-266-3916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty