Provider Demographics
NPI:1427332212
Name:GIRLS IN PINK MASTECTOMY PRODUCTS
Entity type:Organization
Organization Name:GIRLS IN PINK MASTECTOMY PRODUCTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-386-6362
Mailing Address - Street 1:15894 SW 85TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-5208
Mailing Address - Country:US
Mailing Address - Phone:305-386-6362
Mailing Address - Fax:305-386-6362
Practice Address - Street 1:15894 SW 85TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-5208
Practice Address - Country:US
Practice Address - Phone:305-386-6362
Practice Address - Fax:305-386-6362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier