Aesthetemed, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

AESTHETEMED, LLC

Practice address

2100 E Hallandale Beach Blvd
100
Hallandale Beach, FL 33009

Phone

(786) 966-7878

NPI assigned

May 24, 2024

Organization subpart

No

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

Authorized official

Name

Vadim Nisenboym

Title

Manager

Phone

(786) 966-7878

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1427897735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E HALLANDALE BEACH BLVD",
            "address_2": "100",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "33009",
            "telephone_number": "786-966-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E HALLANDALE BEACH BLVD",
            "address_2": "100",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "33009",
            "telephone_number": "786-966-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETEMED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "NISENBOYM",
        "authorized_official_first_name": "VADIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "786-966-7878"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION",
            "identifier": "6025783",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION",
            "identifier": "CE10037989",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Hallandale Beach, FL
• Providers in Hallandale Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.