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General NPI Number Information
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NPI Number | 1578873006
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Entity Type | Organization
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Legal Business Name | BEAUTIFUL ME
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 2301 N. UNIVERSITY DRIVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-965-1119
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Fax | 954-965-0119
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Provider Business Mailing Address
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Address Line | PO BOX 823902
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City | PEMBROKE
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State | FL
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Zip | 33082
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Country | US
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Telephone | 954-965-1119
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Fax | 954-965-0119
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. JUDE GIBBS
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Credential | RN
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Telephone | 954-965-1119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 132700000X
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Taxonomy Name | Dietary Manager
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License Number |
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License Number State | FL
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