1124334297 NPI number — M&C IMPERIAL HAIR CENTER

Table of content: (NPI 1124334297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124334297 NPI number — M&C IMPERIAL HAIR CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
M&C IMPERIAL HAIR CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
IMPERIAL HAIR CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124334297
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8826 MIRAMAR PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIRAMAR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33025-2732
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-441-3811
Provider Business Mailing Address Fax Number:
954-435-4867

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8826 MIRAMAR PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIRAMAR
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33025-2732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-441-3811
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/26/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CADET
Authorized Official First Name:
MYRIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/EXTENSION SPECIALIST
Authorized Official Telephone Number:
305-978-7202

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)