Healthcare Provider Details

I. General information

NPI: 1184381717
Provider Name (Legal Business Name): PAMELA MAIR HLSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 N FEDERAL HWY UNIT 208
POMPANO BEACH FL
33062-1018
US

IV. Provider business mailing address

2523 SAWYER TER
WELLINGTON FL
33414-6485
US

V. Phone/Fax

Practice location:
  • Phone: 561-351-3186
  • Fax:
Mailing address:
  • Phone: 613-513-1865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: