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General NPI Number Information
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NPI Number | 1144357856
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Entity Type | Organization
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Legal Business Name | SECRETLY YOURS ENT INC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 9121 N MILITARY TRL STE 105
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City | WEST PALM BEACH
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State | FL
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Zip | 33410-5985
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Country | US
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Telephone | 561-694-5970
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Fax | 561-694-5972
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Provider Business Mailing Address
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Address Line | 9121 N MILITARY TRAIL SUITE 105
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410
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Country | US
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Telephone | 561-694-5970
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Fax | 561-694-5972
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Authorized Official
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Title or Position | OWNER
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Name | MS. JODI L DAVIS
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Credential |
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Telephone | 561-694-5970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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