LIFESHAPES BOUTIQUE INC (NPI# 1316047350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316047350 |
| Entity Type | Organization |
| Organization Name | LIFESHAPES BOUTIQUE INC |
| Practice Address |
518 Lakewood Dr Brandon FL 33510-4037 |
| Practice Telephone | 8136546968 |
| Practice Fax Number | 8136556968 |
| Mailing Telephone | 8136546968 |
| Mailing Fax Number | 8136556968 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. FELICIA NORIEGA DICKEY (OWNER) |
| Authorized Official Telephone | 8136296331 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | M2444 | 01 |
| Street Address |
518 LAKEWOOD DR |
| City | BRANDON |
| State | FL |
| Zip Code | 33510-4037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215491204 | Juliana Giraldo-isaza | Technician, Other | 1116 Nikki View Dr., Brandon, FL 33510 | 2019-01-24 |
| 1952813511 | Tanya Samuels | Respite Care | 502 Camino Real Court Atp A, Brandon, FL 33510 | 2017-11-03 |
| 1518482462 | Ava Cares, LLC | Assisted Living Facility | 713 Pearl Circle, Brandon, FL 33510 | 2017-08-11 |
| 1790208510 | Gps Pharmacy-tampa LLC | Pharmacy | 2846 Broadway Center Blvd, Brandon, FL 33510 | 2017-07-24 |
| 1356886345 | Marguerita La Cruz | Early Intervention Provider Agency | 1720 Southwind Dr., Brandon, FL 33510 | 2016-12-29 |
| 1215487434 | Cottage Manor, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1706 Cottage Oaks Ct, Brandon, FL 33510 | 2016-10-12 |
| 1558817874 | Tracy Cheri Speech Therapy Services | Speech-Language Pathologist | 701 Hazy Meadow Ct., Brandon, FL 33510 | 2016-08-28 |
| 1144672338 | Brandy Sweet | Licensed Practical Nurse | 221 N Kings Ave, Apt 226, Brandon, FL 33510 | 2016-07-12 |
| 1750733945 | Eddie James Burrell Jr. | Nurse's Aide | 221 N Kings Ave #226, Brandon, FL 33510 | 2016-07-12 |
| 1760842280 | Sunny Sia | Nurse Practitioner | 205 W Morgan St, Brandon, FL 33510 | 2016-02-25 |
| Find all providers in zip 33510 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114546462 | Nehemiah Levi Brown | Prosthetic/Orthotic Supplier | 111 Sara Fox Dr, Brandon, MS 39047-5527 | 2020-04-15 |
| 1740565860 | A New You Pink Boutique | Prosthetic/Orthotic Supplier | 106 W Robertson St, Brandon, FL 33511-5112 | 2011-10-20 |
| 1982884029 | Southern Brace & Billing LLC | Prosthetic/Orthotic Supplier | 1700 W Government St, Building A Suite C, Brandon, MS 39042-2417 | 2007-11-06 |
| 1861685083 | Tampa Bay Orthopaedic Designs, Inc. | Prosthetic/Orthotic Supplier | 667 S Kings Ave, Brandon, FL 33511-4885 | 2007-08-21 |
| 1568555126 | Hanger Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 1119 Professional Park Dr, Brandon, FL 33511-4887 | 2006-10-02 |
| 1972510501 | Westcoast Brace & Limb | Prosthetic/Orthotic Supplier | 620 Oakfield Drive, Brandon, FL 33511 | 2006-08-03 |
| 1740801695 | Unified Prosthetics and Orthotics, LLC. | Prosthetic/Orthotic Supplier | 111 Sara Fox Dr, Brandon, MS 39047-5527 | 2020-05-01 |
| 1225191729 | Musculoskeletal Institute Chartered | Prosthetic/Orthotic Supplier | 560 S Lakewood Dr Ste 101, Brandon, FL 33511 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073120192 | Solaris Ortho, LLC | Prosthetic/Orthotic Supplier | 1112 W Shell Point Rd Ste 304, Ruskin, FL 33570-3400 | 2020-09-24 |
| 1467068635 | Laquavian Eliacin | Prosthetic/Orthotic Supplier | 1738 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5467 | 2020-09-22 |
| 1831705805 | Fourroux Prosthetics, Inc | Prosthetic/Orthotic Supplier | 5453 N 59th St, Tampa, FL 33610-2011 | 2020-09-16 |
| 1790397875 | Gessy Rigaud | Prosthetic/Orthotic Supplier | 5100 Sw 41st St Apt 115, Hollywood, FL 33023-6988 | 2020-08-19 |
| 1609486737 | Beauty Vault Lux LLC. | Prosthetic/Orthotic Supplier | 5100 Sw 41st St, Hollywood, FL 33023-6948 | 2020-08-04 |
| 1003424680 | Spartan Capital Investments | Prosthetic/Orthotic Supplier | 1621 E Edgewood Dr Ste B, Lakeland, FL 33803-3365 | 2020-07-20 |
| 1518583012 | Ts&a Medical Supply LLC | Prosthetic/Orthotic Supplier | 13555 Automobile Blvd Ste 650, Clearwater, FL 33762-3854 | 2020-06-19 |
| 1962027128 | Qbc Durable Medical Equipment | Prosthetic/Orthotic Supplier | 931 Village Blvd # 256, West Palm Beach, FL 33409-1803 | 2020-06-13 |
| 1083239891 | K.n. Medical Wigs Inc | Prosthetic/Orthotic Supplier | 651 E Main St Ste I, Haines City, FL 33844-4240 | 2020-06-08 |
| 1730703851 | Mahnke's Orthotics & Prosthetics of Deerfield Inc | Prosthetic/Orthotic Supplier | 4208 N 31st Ave Ste 2, Hollywood, FL 33021-2002 | 2020-06-04 |
| 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.