Organization Active NPI

Beyondbela Aesthetics & Wellness Corp

  • Emergency Medicine Physician
  • Brandon, FL
National Provider Identifier
1700512738
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
BEYONDBELA AESTHETICS & WELLNESS CORP
Practice address
201 E Robertson St
Brandon, FL 33511-5234
Phone
(813) 655-7621
NPI assigned
Aug 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Authorized official

Name
Mrs. Jessica Villalon
Title
Billing
Phone
(813) 345-7070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

201 E Robertson St
Brandon, FL 33511-5234

Mailing address

201 E Robertson St
Brandon, FL 33511-5234
Phone (813) 655-7621

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dimaravega@beyondbela.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

201 E Robertson St
Brandon, FL 33511
Phone (813) 655-7621

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": "1659312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1700512738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E ROBERTSON ST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115234",
            "telephone_number": "813-655-7621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E ROBERTSON ST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115234",
            "telephone_number": "813-655-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEYONDBELA AESTHETICS & WELLNESS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "VILLALON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "813-345-7070",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dimaravega@beyondbela.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email received all files PDF, CSV Etc",
            "address_1": "201 E Robertson St",
            "city": "Brandon",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335115234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.