Provider Demographics
NPI:1952126393
Name:THE D1V1N3 LLC
Entity type:Organization
Organization Name:THE D1V1N3 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHMEADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-638-1004
Mailing Address - Street 1:8406 N 16TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-1980
Mailing Address - Country:US
Mailing Address - Phone:407-638-1004
Mailing Address - Fax:
Practice Address - Street 1:8406 N 16TH ST APT A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-1980
Practice Address - Country:US
Practice Address - Phone:407-638-1004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty