MEDICARE: J LATIMORE HAIR STUDIO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1659200087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J LATIMORE HAIR STUDIO LLC

Provider Business Mailing Address
First Line	:	6 LARCH AVE STE 397
Second Line	:
City	:	NEWPORT
State	:	DE
Zip	:	19804-2356
Country	:	US
Telephone Number	:	302-599-1932
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 LARCH AVE STE 397
Second Line	:
City	:	NEWPORT
State	:	DE
Zip	:	19804-2356
Country	:	US
Telephone Number	:	302-599-1932
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JUANITA LATIMORE
Credential	:
Telephone Number	:	347-873-1664

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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Directions to “J LATIMORE HAIR STUDIO LLC ” Practice Location

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