Provider Demographics
NPI:1285278002
Name:SOLE NATURALE WELLNESS FEET CARE INC
Entity type:Organization
Organization Name:SOLE NATURALE WELLNESS FEET CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAMARRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-228-5610
Mailing Address - Street 1:PO BOX 450058
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33345-0058
Mailing Address - Country:US
Mailing Address - Phone:954-228-5610
Mailing Address - Fax:
Practice Address - Street 1:4440 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-5789
Practice Address - Country:US
Practice Address - Phone:954-228-5610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies