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General NPI Number Information
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NPI Number | 1659828424
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Entity Type | Organization
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Legal Business Name | SNEAKZ LLC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 10/22/2018
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Provider Practice Location Address
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Address Line | 2875 JUPITER PARK DR SUITE 1600
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City | JUPITER
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State | FL
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Zip | 33458-6058
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Country | US
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Telephone | 561-529-3086
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Fax |
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Provider Business Mailing Address
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Address Line | 2895 JUPITER PARK DR STE 500
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City | JUPITER
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State | FL
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Zip | 33458-6049
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Country | US
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Telephone | 561-529-3086
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. JEFFERY ROBBINS
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Credential |
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Telephone | 561-529-3086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335G00000X
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Taxonomy Name | Medical Foods Supplier
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License Number |
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License Number State |
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