MEDICARE: HEART STRINGS BOUTIQUE 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1780536938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART STRINGS BOUTIQUE LLC

Provider Business Mailing Address
First Line	:	1131 N DIXIE FWY
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-6069
Country	:	US
Telephone Number	:	386-427-6344
Fax Number	:	855-250-9392

Provider Business Practice Location Address
First Line	:	1131 N DIXIE FWY
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-6069
Country	:	US
Telephone Number	:	386-427-6344
Fax Number	:	855-250-9392

Authorized Official
Title or Position	:	OWNER
Name	:	PAIGE L CHILDRESS
Credential	:	CFM
Telephone Number	:	386-427-6344

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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