Provider Demographics
NPI:1164731626
Name:SUCCESS WITH NO LIMITS
Entity Type:Organization
Organization Name:SUCCESS WITH NO LIMITS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIATIKQUA
Authorized Official - Middle Name:TIONSHAY
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-401-7662
Mailing Address - Street 1:948 NW 58TH CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34482-5186
Mailing Address - Country:US
Mailing Address - Phone:352-401-7662
Mailing Address - Fax:352-622-6315
Practice Address - Street 1:948 N W 58TH COURT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482
Practice Address - Country:US
Practice Address - Phone:352-401-7662
Practice Address - Fax:352-622-6315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL000453000302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization