NPI | 1437429073 |
---|---|
Former Legal Business Name | CELEBRITY MEDICAL SPA, LLC |
Entity Type | Organization |
Authorized Contact | ELDAR BOLATOVICH BAIGABATOV President 407-347-9886 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Enumeration Date | 2012-01-12 |
Last Update Date | 2015-12-22 |