Provider Demographics
NPI:1518602036
Name:VK BEAUTY AESTHETIC MEDICAL PROFESSIONALS LLC
Entity type:Organization
Organization Name:VK BEAUTY AESTHETIC MEDICAL PROFESSIONALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIRENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALVAT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-909-7485
Mailing Address - Street 1:50 PEN NA NA DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5230
Mailing Address - Country:US
Mailing Address - Phone:786-909-7485
Mailing Address - Fax:
Practice Address - Street 1:1254 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3502
Practice Address - Country:US
Practice Address - Phone:306-364-5880
Practice Address - Fax:786-629-5437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1174164651OtherNPI