AGELESS AESTHETIC CENTER, LLC — NPI 1124264973 (Licensed & Credentialed Phlebology in WESTON, FL)

CMS-1500 Box 24J / 33a • NPI

1124264973

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

202K00000X

Licensed & Credentialed Phlebology

Box 32 Service Location & ZIP+4

2665 EXECUTIVE PARK DR, SUITE 1, WESTON, FL, 33331-3652

✓ 9-Digit EDI 837 ZIP+4 (33331-3652)

Practice Phone & Referral Fax

(954) 454-4900

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1124264973 (AGELESS AESTHETIC CENTER, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1124264973` (NPI-2 Organization / Facility)
Provider / Legal Name	AGELESS AESTHETIC CENTER, LLC
Plain-English Specialty	Licensed & Credentialed Phlebology NUCC Code: `202K00000X` (Phlebology)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2665 EXECUTIVE PARK DR, SUITE 1, WESTON, FL, 33331-3652
Practice Telephone / Fax	Tel: (954) 454-4900
Administrative Mailing Address	2665 EXECUTIVE PARK DR, WESTON, FL, 33331-3652
Enumeration & Last Sync	Enumerated: 2008-12-29 \| CMS Record Updated: 2008-12-29
Authorized Official	ALFONSO RIVIEZZO (Billing Manager)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2665 EXECUTIVE PARK DR, SUITE 1, WESTON, FL, 33331-3652

🗺️ Open in Google Maps 🏥 More Providers in WESTON

🔒 Are you AGELESS AESTHETIC CENTER, LLC? Get your Verified NPI Clinic Badge or request personal phone/address redaction →

Plain-English Taxonomy & CMS Crosswalk (202K00000X)

What Does Taxonomy Code 202K00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 202K00000X translates to:
"Licensed & Credentialed Phlebology"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Phlebology for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AGELESS AESTHETIC CENTER, LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`202K00000X` — Phlebology Plain English: Licensed & Credentialed Phlebology	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.

Launch Bulk NPI Checker → JSON API Docs

AGELESS AESTHETIC CENTER, LLC (NPI #1124264973)