Provider Demographics
NPI:1548575939
Name:LANCASTER, LASHAUNTE SHUNTARIO (COSMETOLOGIST)
Entity Type:Individual
Prefix:
First Name:LASHAUNTE
Middle Name:SHUNTARIO
Last Name:LANCASTER
Suffix:
Gender:F
Credentials:COSMETOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 SW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2148
Mailing Address - Country:US
Mailing Address - Phone:954-588-8641
Mailing Address - Fax:
Practice Address - Street 1:5945 W HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-5245
Practice Address - Country:US
Practice Address - Phone:954-241-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCL1171630174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist