Provider Demographics
NPI:1780190793
Name:ALL CARE WELLNESS AND AESTHETICS, LLC
Entity Type:Organization
Organization Name:ALL CARE WELLNESS AND AESTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:ILYAS
Authorized Official - Last Name:YAMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-767-0950
Mailing Address - Street 1:8900 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33777-4119
Mailing Address - Country:US
Mailing Address - Phone:727-767-0950
Mailing Address - Fax:727-440-7292
Practice Address - Street 1:8900 PARK BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33777-4119
Practice Address - Country:US
Practice Address - Phone:727-767-0950
Practice Address - Fax:727-440-7292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-28
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70978207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty