Bon Salut Organic Med Spa

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BON SALUT ORGANIC MED SPA

Practice address

14846 Tamiami TRL
North Port, FL 34287-2701

Phone

(941) 876-3577

NPI assigned

Jul 17, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Anne Marie Farag

Title

Director Owner

Phone

(727) 692-9465

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563753600000",
    "number": "1972156289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14846 TAMIAMI TRL",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342872701",
            "telephone_number": "941-876-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14846 TAMIAMI TRL",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342872701",
            "telephone_number": "941-876-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SALUT ORGANIC MED SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-22",
        "status": "A",
        "authorized_official_last_name": "FARAG",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OWNER",
        "authorized_official_telephone_number": "727-692-9465",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003885815",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luis E Blanco
• Sally Blanco
• Sarah Bland
• Allison Elizabeth Blankley, AA, RBT
• Brandon Blevins, LMT
• Carley Bond
• Samantha Maria Bono, PA-C
• Catalina Borges
• Roman Borukhov
• Michael Borza

• Primary Care Clinic/Center in North Port, FL
• Providers in North Port, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.