NPIMap

Organization Active NPI

Anti Aging Aesthetic and Laser Center Inc

  • Ambulatory Surgical Clinic/Center
  • Miami, FL
National Provider Identifier
1144546789
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
OSR 674 Issued in FL
Legal business name
ANTI AGING AESTHETIC AND LASER CENTER INC
Practice address
175 SW 7TH St
Suite 1710
Miami, FL 33130-2992
Phone
(786) 539-4901
Fax
(786) 539-4904
NPI assigned
Apr 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Authorized official

Name
Oleg Rybak
Title
Owner/President
Phone
(786) 539-4901

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Surgery of the Hand (Plastic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2082S0105X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Ambulatory Surgical Clinic/Center 261QA1903X OSR 674 FL Primary
Multi-Specialty Clinic/Center 261QM1300X HCC8118 FL

Addresses

Primary practice location

175 SW 7TH St
Suite 1710
Miami, FL 33130-2992

Mailing address

175 SW 7TH St
Suite 1710
Miami, FL 33130-2992
Phone (786) 539-4901

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1144546789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 SW 7TH ST",
            "address_2": "SUITE 1710",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331302992",
            "telephone_number": "786-539-4901",
            "fax_number": "786-539-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 SW 7TH ST",
            "address_2": "SUITE 1710",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331302992",
            "telephone_number": "786-539-4901",
            "fax_number": "786-539-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTI AGING AESTHETIC AND LASER CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-07",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "RYBAK",
        "authorized_official_first_name": "OLEG",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "786-539-4901"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "OSR 674",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": "HCC8118",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; 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.