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General NPI Number Information
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NPI Number | 1548951916
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Entity Type | Organization
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Legal Business Name | THE CROWNED KINGDOM LLC
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 2450 SWEETWATER COUNTRY CLUB DR
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City | APOPKA
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State | FL
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Zip | 32712-2579
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Country | US
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Telephone | 351-708-1205
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Fax |
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Provider Business Mailing Address
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Address Line | 3065 DANIELS RD
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City | WINTER GARDEN
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State | FL
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Zip | 34787-7002
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | ROMY DELIA
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Credential |
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Telephone | 352-708-1205
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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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