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General NPI Number Information
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NPI Number | 1457864522
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Entity Type | Organization
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Legal Business Name | BARBERFOLIO LLC
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 11/13/2017
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Provider Practice Location Address
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Address Line | 2224 FLORA AVE
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City | FORT MYERS
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State | FL
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Zip | 33907-4245
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Country | US
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Telephone | 239-271-5056
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Fax |
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Provider Business Mailing Address
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Address Line | 2224 FLORA AVE
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City | FORT MYERS
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State | FL
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Zip | 33907-4245
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Country | US
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Telephone | 239-271-5056
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Fax |
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Authorized Official
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Title or Position | HAIR LOSS SPECIALIST
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Name | JONATHAN JIMENEZ
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Credential |
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Telephone | 239-271-5056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number | 1213036
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License Number State | FL
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