Provider Demographics
NPI:1902482540
Name:BRICKELL SKIN CARE CORP
Entity Type:Organization
Organization Name:BRICKELL SKIN CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERNAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-456-6001
Mailing Address - Street 1:2730 SW 3RD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2323
Mailing Address - Country:US
Mailing Address - Phone:305-456-6001
Mailing Address - Fax:
Practice Address - Street 1:2730 SW 3RD AVE STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-2323
Practice Address - Country:US
Practice Address - Phone:305-456-6001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty