Provider Demographics
NPI:1013621465
Name:LELITE HAIR AND MORE BEAUTY STUDIO LLC
Entity Type:Organization
Organization Name:LELITE HAIR AND MORE BEAUTY STUDIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELISCA
Authorized Official - Suffix:
Authorized Official - Credentials:COSMETOLOGY
Authorized Official - Phone:239-465-6163
Mailing Address - Street 1:27499 RIVERVIEW CENTER BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-4329
Mailing Address - Country:US
Mailing Address - Phone:239-465-6163
Mailing Address - Fax:
Practice Address - Street 1:28441 S TAMIAMI TRL STE 108
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-3213
Practice Address - Country:US
Practice Address - Phone:239-465-6163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier