Provider Demographics
NPI:1447413778
Name:LADIES IN PINK BOUTIQUE LLC
Entity Type:Organization
Organization Name:LADIES IN PINK BOUTIQUE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:JULIO
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-267-6990
Mailing Address - Street 1:271 NW 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-8339
Mailing Address - Country:US
Mailing Address - Phone:305-267-6990
Mailing Address - Fax:305-267-6989
Practice Address - Street 1:271 NW 82ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-8339
Practice Address - Country:US
Practice Address - Phone:305-267-6990
Practice Address - Fax:305-267-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier