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General NPI Number Information
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NPI Number | 1871254185
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Entity Type | Organization
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Legal Business Name | FAIR LIFESAVERS
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Dates
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Enumeration Date | 01/08/2022
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Last Update Date | 01/08/2022
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Provider Practice Location Address
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Address Line | 7 W MAIN ST STE 100
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City | APOPKA
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State | FL
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Zip | 32703-5185
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Country | US
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Telephone | 407-670-0910
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Fax |
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Provider Business Mailing Address
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Address Line | 497 E CLEVELAND ST
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City | APOPKA
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State | FL
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Zip | 32703-7224
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Country | US
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Telephone | 321-689-8961
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMILIA S FAIR
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Credential | APRN
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Telephone | 321-689-8961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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