Provider Demographics
NPI:1104179761
Name:PANDA KITCHEN CABINETS AND VANITIES
Entity Type:Organization
Organization Name:PANDA KITCHEN CABINETS AND VANITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ISMAEL
Authorized Official - Last Name:ARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-322-9089
Mailing Address - Street 1:6412 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2138
Mailing Address - Country:US
Mailing Address - Phone:954-322-9089
Mailing Address - Fax:954-322-9088
Practice Address - Street 1:6412 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-2138
Practice Address - Country:US
Practice Address - Phone:954-322-9089
Practice Address - Fax:954-322-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL07000396332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment