Provider Demographics
NPI:1811386055
Name:MASSIVE MARKETING GROUP II LLC
Entity Type:Organization
Organization Name:MASSIVE MARKETING GROUP II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESTILL
Authorized Official - Middle Name:
Authorized Official - Last Name:TAPIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-806-9309
Mailing Address - Street 1:7351 WILES RD
Mailing Address - Street 2:SUITE #103
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4106
Mailing Address - Country:US
Mailing Address - Phone:954-806-9309
Mailing Address - Fax:
Practice Address - Street 1:7351 WILES RD
Practice Address - Street 2:SUITE #103
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4106
Practice Address - Country:US
Practice Address - Phone:954-806-9309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy