| Aesthetemed, Llc | |
|
2100 E Hallandale Beach Blvd 100 Hallandale Beach FL 33009 | |
| (786) 966-7878 | |
| Not Available |
| Full Name | Aesthetemed, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2100 E Hallandale Beach Blvd, Hallandale Beach, Florida |
| Authorized Official Name and Position | Vadim Nisenboym (MANAGER) |
| Authorized Official Contact | 7869667878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aesthetemed, Llc 2100 E Hallandale Beach Blvd 100 Hallandale Beach FL 33009 Ph: (786) 966-7878 | Aesthetemed, Llc 2100 E Hallandale Beach Blvd 100 Hallandale Beach FL 33009 Ph: (786) 966-7878 |
| NPI Number | 1427897735 |
|---|---|
| Provider Enumeration Date | 05/24/2024 |
| Last Update Date | 05/24/2024 |
| Medicare PECOS PAC ID | 8921547043 |
|---|---|
| Medicare Enrollment ID | O20240903002124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427897735 | NPI | - | NPPES |
| 6025783 | Other | FL | DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION |
| CE10037989 | Other | FL | DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Yadira Mendoza Medina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730805292 PECOS PAC ID: 6608315734 Enrollment ID: I20240903002383 |
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