Medspa & Primary Care LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

MEDSPA & PRIMARY CARE LLC

Practice address

825 E Cowboy Way Ste 106
Labelle, FL 33935-4491

Phone

(863) 230-8163

Fax

(863) 230-8273

NPI assigned

Jan 18, 2024

Organization subpart

No

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

Authorized official

Name

Ahitza Carrazana Estrada

Title

Aprn

Phone

(863) 230-8163

Specialties & licenses 1

Addresses

Other names 1

• LaBelle MedSpa & Wellness Center Doing business as

Locations

Practitioners 1

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

• Andres Felix Espinosa de Los Monteros

  • Behavior Analyst
  • Miami, FL
  • NPI 1396309142

  Single Specialty

  NPD

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1548021314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E COWBOY WAY STE 106",
            "city": "LABELLE",
            "state": "FL",
            "postal_code": "339354491",
            "telephone_number": "863-230-8163",
            "fax_number": "863-230-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E COWBOY WAY STE 106",
            "city": "LABELLE",
            "state": "FL",
            "postal_code": "339354491",
            "telephone_number": "863-230-8163",
            "fax_number": "863-230-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSPA & PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "CARRAZANA ESTRADA",
        "authorized_official_first_name": "AHITZA",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "863-230-8163"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LaBelle MedSpa & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LaBelle MedSpa & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Silvana Matos Vales
• Jose Matos
• Kaci McCullers, RN
• Bryan McInnes
• Adam L McQuaig
• Mirna Maria Mendez Gonzalez - Pardo
• Elizabeth Joan Midney-Martinez, M.D.
• Kenneth Chester Miles, D.D.S.
• Yusleidis Milian de la Pena
• Nathalie Sophia Molina

• Health Service Clinic/Center in Labelle, FL
• Providers in Labelle, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.