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General NPI Number Information
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NPI Number | 1306506555
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Entity Type | Organization
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Legal Business Name | SOPHIAPLUSS HAIR LOSS THERAPY INC
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Dates
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Enumeration Date | 12/28/2021
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 674 N UNIVERSITY DR # 8
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6738
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Country | US
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Telephone | 954-934-4976
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Fax | 954-665-0550
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Provider Business Mailing Address
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Address Line | 674 N UNIVERSITY DR # 8
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6738
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Country | US
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Telephone | 954-934-4976
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Fax | 954-665-0550
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Authorized Official
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Title or Position | OWNER
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Name | PROPHIDA BIEN AIME
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Credential | ORIENTAL MEDINE
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Telephone | 954-665-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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