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General NPI Number Information
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NPI Number | 1700547189
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Entity Type | Organization
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Legal Business Name | TOTAL PERFECTION HAIR DESIGN LLC
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Dates
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Enumeration Date | 01/06/2022
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 2020 S COMBEE RD STE 3
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City | LAKELAND
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State | FL
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Zip | 33801-6800
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Country | US
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Telephone | 813-421-0048
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 STAUNTON AVE
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City | LAKELAND
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State | FL
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Zip | 33803-2551
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Country | US
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Telephone | 863-594-6525
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Fax |
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Authorized Official
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Title or Position | CERTIFIED HAIR LOSS SPECIALIST
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Name | MS. SHARITA LASHUN HAWKINS
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Credential |
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Telephone | 813-421-0048
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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 |
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License Number State |
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