Metamorphosis Medispa & Wellness Center

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

METAMORPHOSIS MEDISPA & WELLNESS CENTER

Practice address

2104 Tyler St
Hollywood, FL 33020-6717

Phone

(561) 275-9522

Fax

(561) 228-0773

NPI assigned

Nov 18, 2014

Organization subpart

No

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

Authorized official

Name

Simone Van - Horne, MDNPI 1225052103

Title

Ceo

Phone

(315) 775-6018

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Simone Van-Horne, MD

  • Internal Medicine Physician
  • Tamarac, FL
  • NPI 1225052103
  NPD Authorized official

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424995200000",
    "number": "1861898843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 TYLER ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206717",
            "telephone_number": "561-275-9522",
            "fax_number": "561-228-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 TYLER ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206717",
            "telephone_number": "561-275-9522",
            "fax_number": "561-228-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAMORPHOSIS MEDISPA & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-18",
        "last_updated": "2015-02-27",
        "status": "A",
        "authorized_official_last_name": "VAN - HORNE",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "315-775-6018",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karezhe Tigineh Mersha, M.D.
• Yunia Mesa Mederos
• Saulo Mesquita
• Alberta Maria Messer, ARNP
• Jennifer Messinger, LMT
• Jahnise Emily Metellus
• Stephanie Metellus
• Kynan Metoyer, PSY.D.
• Metro Treatment of Florida, LP
• Metrocare Healthcare Systems, Inc

• Internal Medicine Physician in Hollywood, FL
• Providers in Hollywood, 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 Feb 27, 2015; 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.