CUSTOM CROWNS NPI 1205321809

NPI Information

  • NPI: 1205321809
  • Provider Name: CUSTOM CROWNS
  • Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
  • Specialization: Customized Equipment
  • Entity Type: Organization
  • Address: 5202 PLUNKETT ST
    HOLLYWOOD, FL
    ZIP 33021
  • Phone: (754) 581-8402

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NPI Details

CUSTOM CROWNS is a customized equipment durable medical equipment medical supplies in Hollywood, FL. CUSTOM CROWNS NPI is 1205321809. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5202 PLUNKETT ST
HOLLYWOOD, FL
ZIP 33021-023
Phone: (754) 581-8402

The provider's authorized official is Tyshawn Martin .
The authorized official title is Founder/ Ceo and has the following contact phone number (305) 788-7779.

The enumeration date for this NPI number is 6/26/2018 and was last updated on 6/26/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistNo
2332BC3200XDurable Medical Equipment & Medical SuppliesCustomized EquipmentYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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