Provider Demographics
NPI:1003412180
Name:P31 ARTISTRY,LLC
Entity Type:Organization
Organization Name:P31 ARTISTRY,LLC
Other - Org Name:P31 STUDIOS HAIR & BEAUTY RESTORATION CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HAIR LOSS PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARASCO
Authorized Official - Suffix:
Authorized Official - Credentials:HLP
Authorized Official - Phone:561-889-1819
Mailing Address - Street 1:1427 10TH ST # 1427
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-2041
Mailing Address - Country:US
Mailing Address - Phone:561-469-9857
Mailing Address - Fax:
Practice Address - Street 1:1427 10TH ST # 1427
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-2041
Practice Address - Country:US
Practice Address - Phone:561-469-9857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-05
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Single Specialty