Provider Demographics
NPI:1730544172
Name:VERO FACIAL COSMETIC SURGERY & MEDISPA ,PLLC
Entity type:Organization
Organization Name:VERO FACIAL COSMETIC SURGERY & MEDISPA ,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATSIRAYNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUSEVA BAILOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-562-2400
Mailing Address - Street 1:1255 37TH ST. SUITE D
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960
Mailing Address - Country:US
Mailing Address - Phone:772-562-2400
Mailing Address - Fax:
Practice Address - Street 1:1255 37TH ST STE D
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6550
Practice Address - Country:US
Practice Address - Phone:772-562-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and NeckGroup - Multi-Specialty