Provider Demographics
NPI:1700547189
Name:TOTAL PERFECTION HAIR DESIGN LLC
Entity Type:Organization
Organization Name:TOTAL PERFECTION HAIR DESIGN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED HAIR LOSS SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARITA
Authorized Official - Middle Name:LASHUN
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-421-0048
Mailing Address - Street 1:1711 STAUNTON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-2551
Mailing Address - Country:US
Mailing Address - Phone:863-594-6525
Mailing Address - Fax:
Practice Address - Street 1:2020 S COMBEE RD STE 3
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-6800
Practice Address - Country:US
Practice Address - Phone:813-421-0048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty