Provider Demographics
NPI:1174285274
Name:INNOVATIVE KNOWLEDGE FOR SUCCESS, LLC
Entity Type:Organization
Organization Name:INNOVATIVE KNOWLEDGE FOR SUCCESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & RESEARCHER
Authorized Official - Prefix:
Authorized Official - First Name:SEQUOAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-716-4962
Mailing Address - Street 1:10850 WEST SAMPLE ROAD
Mailing Address - Street 2:#6504
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-716-4962
Mailing Address - Fax:
Practice Address - Street 1:10850 WEST SAMPLE ROAD
Practice Address - Street 2:#6504
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-716-4962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/CoderGroup - Single Specialty