Provider Demographics
NPI:1356764062
Name:BEAUTY & BODY FOREVER INC
Entity type:Organization
Organization Name:BEAUTY & BODY FOREVER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ODILIA
Authorized Official - Middle Name:DE LA CARIDAD
Authorized Official - Last Name:VIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-853-4206
Mailing Address - Street 1:935A SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3206
Mailing Address - Country:US
Mailing Address - Phone:786-853-4206
Mailing Address - Fax:
Practice Address - Street 1:935A SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3206
Practice Address - Country:US
Practice Address - Phone:786-853-4206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA67896225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty