Provider Demographics
NPI:1619748761
Name:QUEEN'S SKIN CARE. LLC
Entity Type:Organization
Organization Name:QUEEN'S SKIN CARE. LLC
Other - Org Name:QUEEN'S SKIN CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAIDIQUE ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:786-238-8645
Mailing Address - Street 1:7171 CORAL WAY STE 104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1684
Mailing Address - Country:US
Mailing Address - Phone:786-238-8645
Mailing Address - Fax:
Practice Address - Street 1:7171 CORAL WAY STE 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1684
Practice Address - Country:US
Practice Address - Phone:786-238-8645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty