Provider Demographics
NPI:1538754080
Name:FLAWLESS AESTHETICS, INC
Entity type:Organization
Organization Name:FLAWLESS AESTHETICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:YANITZA
Authorized Official - Last Name:RODRIGUEZ GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:939-383-9927
Mailing Address - Street 1:1601 JOHNS LAKE RD APT 225
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6657
Mailing Address - Country:US
Mailing Address - Phone:939-383-9927
Mailing Address - Fax:
Practice Address - Street 1:1601 JOHNS LAKE RD APT 225
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6657
Practice Address - Country:US
Practice Address - Phone:939-383-9927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-06
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty