Provider Demographics
NPI:1497413520
Name:SKINNERGIE LLC
Entity Type:Organization
Organization Name:SKINNERGIE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GETER GAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-270-8375
Mailing Address - Street 1:18830 NW 44TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-2626
Mailing Address - Country:US
Mailing Address - Phone:786-270-8375
Mailing Address - Fax:
Practice Address - Street 1:4330 W BROWARD BLVD STE O
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3754
Practice Address - Country:US
Practice Address - Phone:786-270-8375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment