Provider Demographics
NPI:1356911770
Name:BELFON HEALTH AND AESTHETICS
Entity type:Organization
Organization Name:BELFON HEALTH AND AESTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TYSHARRA
Authorized Official - Middle Name:KENYATTA
Authorized Official - Last Name:BELFON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:786-412-1150
Mailing Address - Street 1:1861 SW 101ST WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6531
Mailing Address - Country:US
Mailing Address - Phone:786-412-1150
Mailing Address - Fax:478-202-9585
Practice Address - Street 1:12064 MIRAMAR PKWY STE 101
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7003
Practice Address - Country:US
Practice Address - Phone:786-412-1150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty