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General NPI Number Information
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NPI Number | 1629688866
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Entity Type | Organization
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Legal Business Name | G LUXE LLC
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 801 W STATE ROAD 436 STE 2013
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3053
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Country | US
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Telephone | 321-710-7006
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Fax |
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Provider Business Mailing Address
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Address Line | 818 RENAISSANCE POINTE APT 201
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3537
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Country | US
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Telephone | 407-844-3205
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STACIE HOLMES
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Credential |
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Telephone | 407-844-3205
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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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