NPIMap

Organization Active NPI

Neos Aesthetics

  • Clinic/Center
  • Tampa, FL
National Provider Identifier
1073294906
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NEOS AESTHETICS
Practice address
4010 W State St
Tampa, FL 33609-1264
Phone
(813) 758-0305
NPI assigned
Jul 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edith L Kavouklis, ARNPNPI 1700399433
Title
Owner/MGR
Phone
(813) 758-0305

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

4010 W State St
Tampa, FL 33609-1264

Mailing address

4010 W State St
Tampa, FL 33609-1264
Phone (813) 758-0305

National Provider Directory

National Provider Directory

Locations

4010 W State St
Tampa, FL 33609
Phone (813) 758-0305

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1073294906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 W STATE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091264",
            "telephone_number": "813-758-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 W STATE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091264",
            "telephone_number": "813-758-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOS AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "KAVOUKLIS",
        "authorized_official_first_name": "EDITH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/MGR",
        "authorized_official_telephone_number": "813-758-0305",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.