Provider Demographics
NPI:1184381717
Name:MAIR, PAMELA (HLSC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:MAIR
Suffix:
Gender:F
Credentials:HLSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2523 SAWYER TER
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6485
Mailing Address - Country:US
Mailing Address - Phone:613-513-1865
Mailing Address - Fax:
Practice Address - Street 1:2001 N FEDERAL HWY UNIT 208
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1018
Practice Address - Country:US
Practice Address - Phone:561-351-3186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management