CUSTOM CROWNS (NPI# 1205321809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205321809 |
| Entity Type | Organization |
| Organization Name | CUSTOM CROWNS |
| Practice Address |
5202 Plunkett St Hollywood FL 33021-8023 |
| Practice Telephone | 7545818402 |
| Mailing Telephone | 3057887779 |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2018-06-26 |
| Authorized Official Name | TYSHAWN MARTIN (FOUNDER/ CEO) |
| Authorized Official Telephone | 3057887779 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | Other Service Providers | ||
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CUSTOM CROWNS | 989 Bluebird Rd, Memphis, TN 38116-4088 |
| Colorado Business Entities | Custom Crowns Collection LLC | 4718 Helena St, Denver, CO 80239 |
| Street Address |
5202 PLUNKETT ST |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021-8023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255963450 | Tyshawn Martin | Licensed Practical Nurse | 5202 Plunkett St, Hollywood, FL 33021-8023 | 2020-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861770695 | Diabetic Science Inc | Durable Medical Equipment & Medical Supplies | 509 S 21st Ave, 102, Hollywood, FL 33020-5037 | 2011-07-27 |
| 1164844528 | Chase Dental Sleepcare of Hollywood Inc. | Durable Medical Equipment & Medical Supplies | 2525 Embassy Dr, #1, Hollywood, FL 33026-4573 | 2014-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356948129 | Heavenly Slayerz Boutique | Durable Medical Equipment & Medical Supplies | 6120 Forest Hill Blvd Apt 110, West Palm Beach, FL 33415-6260 | 2020-10-05 |
| 1649884297 | Dbl Mobility Care Inc | Durable Medical Equipment & Medical Supplies | 132 Sw Monterey Rd, Stuart, FL 34994-4610 | 2020-09-01 |
| 1942812649 | Homeward Bound Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 3836 Old Dixie Hwy, Stuart, FL 34997 | 2020-08-24 |
| 1255956744 | Synergy Health Care and Associates | Durable Medical Equipment & Medical Supplies | 124 Marriott Dr, Tallahassee, FL 32301-2995 | 2020-06-10 |
| 1770118705 | New Regeneration Orthopedics of Florida, Pllc. | Durable Medical Equipment & Medical Supplies | 20754 W Dixie Hwy Unit 2c, Miami, FL 33180-1146 | 2020-03-10 |
| 1770118309 | 6th St. Bridge Mobility and Home Care LLC | Durable Medical Equipment & Medical Supplies | 7818 Depot Ln, Tampa, FL 33637-6810 | 2020-03-04 |
| 1033741681 | 123germfree, LLC | Durable Medical Equipment & Medical Supplies | 4537 Prime Ter, North Port, FL 34286-7707 | 2020-02-11 |
| 1053951632 | Somnia Sleep Solutions LLC | Durable Medical Equipment & Medical Supplies | 205 Zeagler Dr Ste 301, Palatka, FL 32177-3860 | 2020-01-10 |
| 1700433067 | Beyoutiful Custom Wigs and Makeup | Durable Medical Equipment & Medical Supplies | 276 N Market Blvd, Webster, FL 33597-9441 | 2019-08-21 |
| 1437710688 | Myrna Rogers | Durable Medical Equipment & Medical Supplies | 11636 Linda Ln, Dade City, FL 33525-8405 | 2019-06-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.