Provider Demographics
NPI:1669234886
Name:BELIZIMA AESTHETICS & WELLNESS, LLC.
Entity type:Organization
Organization Name:BELIZIMA AESTHETICS & WELLNESS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:813-751-5691
Mailing Address - Street 1:3803 SHORESIDE CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2310
Mailing Address - Country:US
Mailing Address - Phone:813-751-5691
Mailing Address - Fax:
Practice Address - Street 1:7603 GUNN HWY STE D
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-3164
Practice Address - Country:US
Practice Address - Phone:813-751-5691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care