Provider Demographics
NPI:1396515391
Name:LOVE, LA'TI PLLC
Entity type:Organization
Organization Name:LOVE, LA'TI PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA / CEO
Authorized Official - Prefix:
Authorized Official - First Name:LA'TIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:CNA, ESTHETICIAN
Authorized Official - Phone:321-986-7978
Mailing Address - Street 1:577 PLAYER LN APT 5
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-4327
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:577 PLAYER LN APT 5
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4327
Practice Address - Country:US
Practice Address - Phone:407-272-7206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty