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General NPI Number Information
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NPI Number | 1841989365
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Entity Type | Organization
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Legal Business Name | ARKEYIA'S MEDICAL CROWN
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 1250 BROOKWOOD FOREST BLVD APT 5208
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City | JACKSONVILLE
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State | FL
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Zip | 32225-9068
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Country | US
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Telephone | 904-257-6560
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Fax |
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Provider Business Mailing Address
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Address Line | 12220 ATLANTIC BLVD STE 130
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City | JACKSONVILLE
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State | FL
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Zip | 32225-5826
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Country | US
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Telephone | 904-257-6560
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Fax |
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Authorized Official
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Title or Position | CRANIAL PROSTHESIS SPECIALIST
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Name | TIFFANY ARKEYIA BURR
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Credential |
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Telephone | 904-258-7213
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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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