| Breeze Aesthetics, Inc | |
|
5763 Stewart Ave Port Orange FL 32127-4703 | |
| (386) 295-3512 | |
| (386) 222-7376 |
| Full Name | Breeze Aesthetics, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5763 Stewart Ave, Port Orange, Florida |
| Authorized Official Name and Position | Ann M Gaffka (PRESIDENT) |
| Authorized Official Contact | 3862953512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Breeze Aesthetics, Inc 5763 Stewart Ave Port Orange FL 32127-4703 Ph: (386) 295-3512 | Breeze Aesthetics, Inc 5763 Stewart Ave Port Orange FL 32127-4703 Ph: (386) 295-3512 |
| NPI Number | 1255051264 |
|---|---|
| Provider Enumeration Date | 08/30/2022 |
| Last Update Date | 03/25/2024 |
| Medicare PECOS PAC ID | 1557735800 |
|---|---|
| Medicare Enrollment ID | O20230328001285 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255051264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Ann M Gaffka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952457483 PECOS PAC ID: 8325182991 Enrollment ID: I20100219000600 |
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