Provider Demographics
NPI:1689373896
Name:MODERNISTIC HEALTH CARE SERVICES INC
Entity Type:Organization
Organization Name:MODERNISTIC HEALTH CARE SERVICES INC
Other - Org Name:ENCHANTED BODYWORKS & SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:954-822-5363
Mailing Address - Street 1:2090 W PRESERVE WAY APT 304
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3909
Mailing Address - Country:US
Mailing Address - Phone:954-822-5363
Mailing Address - Fax:
Practice Address - Street 1:11322 MIRAMAR PKWY # 1214
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-5805
Practice Address - Country:US
Practice Address - Phone:833-663-3760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MODERNISTIC HEALTH CARE SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-27
Last Update Date:2023-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service