Provider Demographics
NPI:1417288200
Name:SUPREME TOUCH INC.
Entity Type:Organization
Organization Name:SUPREME TOUCH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:VILMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRAMEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-290-3012
Mailing Address - Street 1:13899 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33181-1600
Mailing Address - Country:US
Mailing Address - Phone:305-341-3518
Mailing Address - Fax:305-341-3517
Practice Address - Street 1:13899 BISCAYNE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33181-1600
Practice Address - Country:US
Practice Address - Phone:305-341-3518
Practice Address - Fax:305-341-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 41724302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization