| NPI | 1639876733 |
|---|---|
| Former Legal Business Name | PELHAM MEDICAL CONSULTING & AESTHETIC LOUNGE, LLC. |
| Entity Type | Organization |
| Authorized Contact | JANADRA DEAN GREENIDGE Owner 407-893-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2023-06-29 |