Provider Demographics
NPI:1952292625
Name:ESSENTIAL AESTHETICS & HEALTH, LLC
Entity type:Organization
Organization Name:ESSENTIAL AESTHETICS & HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LESTRADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:547-778-7375
Mailing Address - Street 1:6801 NW 46TH CT
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4024
Mailing Address - Country:US
Mailing Address - Phone:954-628-6807
Mailing Address - Fax:
Practice Address - Street 1:1975 E SUNRISE BLVD STE 615
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-1453
Practice Address - Country:US
Practice Address - Phone:754-778-7375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center