| NPI | 1396014536 |
|---|---|
| Doing Business As | PRANA BLU MEDSPA |
| Entity Type | Organization |
| Authorized Contact | BETHZALI DEL C. PHILLIPS Managing Memeber 727-330-7733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME86204) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |