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General NPI Number Information
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NPI Number | 1851071708
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Entity Type | Organization
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Legal Business Name | PRESTIGE EXPRESS ENTERPRISES
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 901 NW 8TH AVE SUITE
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City | B-10
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State | FL
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Zip | 32601
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Country | US
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Telephone | 877-242-9816
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Fax |
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Provider Business Mailing Address
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Address Line | 1481 SE 36TH ST
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City | GAINESVILLE
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State | FL
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Zip | 32641-8854
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Country | US
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Telephone | 904-942-1305
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAKEISHA ANN KELLY
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Credential |
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Telephone | 904-942-1305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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