Provider Demographics
NPI:1912217860
Name:CUERPOS HEALTH & AESTHETIC, LLC
Entity Type:Organization
Organization Name:CUERPOS HEALTH & AESTHETIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MASSAGE THERAPIST
Authorized Official - Prefix:PROF
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ALINA
Authorized Official - Last Name:JULIA
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:305-265-0957
Mailing Address - Street 1:7959 S.W. 2 STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-8000
Mailing Address - Country:US
Mailing Address - Phone:305-265-0957
Mailing Address - Fax:305-265-0063
Practice Address - Street 1:7959 NW 2ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-8000
Practice Address - Country:US
Practice Address - Phone:305-265-0957
Practice Address - Fax:305-265-0063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA48285174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLLICENSE MA48285OtherMASSAGE THERAPIST
FLLICENSE MA48285OtherMASSAGE THERAPIST