Provider Demographics
NPI:1700605318
Name:EPIC BEAUTY AND WELLNESS LLC
Entity type:Organization
Organization Name:EPIC BEAUTY AND WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:YON-FLEITES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-239-2122
Mailing Address - Street 1:13895 SW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6612
Mailing Address - Country:US
Mailing Address - Phone:786-239-2122
Mailing Address - Fax:
Practice Address - Street 1:1412 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-4505
Practice Address - Country:US
Practice Address - Phone:786-339-8100
Practice Address - Fax:786-446-8609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty