CUSTOM CROWNS NPI 1538813910

NPI Information

NPI: 1538813910
Provider Name: CUSTOM CROWNS
Classification: Technician, Pathology - 246RM2200X
Specialization: Medical Laboratory
Entity Type: Organization
Address: 5400 S UNIVERSITY DR
DAVIE, FL
ZIP 33328
Phone: (954) 947-0641

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NPI Details

CUSTOM CROWNS is a medical laboratory technician pathology in Davie, FL. CUSTOM CROWNS NPI is 1538813910. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5400 S UNIVERSITY DR
DAVIE, FL
ZIP 33328-312
Phone: (954) 947-0641

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

The enumeration date for this NPI number is 2/4/2022 and was last updated on 2/4/2022.

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	Primary
1	2080P0006X	Pediatrics	Developmental - Behavioral Pediatrics	No
2	247ZC0005X	Pathology	Clinical Laboratory Director, Non-physician	No
3	261Q00000X	Clinic/Center		No
4	261QC1500X	Clinic/Center	Community Health	No
5	261QH0100X	Clinic/Center	Health Service	No
6	261QI0500X	Clinic/Center	Infusion Therapy	No
7	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
8	261QM1300X	Clinic/Center	Multi-Specialty	No
9	261QX0100X	Clinic/Center	Occupational Medicine	No
10	291U00000X	Clinical Medical Laboratory		No
11	246RM2200X	Technician, Pathology	Medical Laboratory	Yes

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: 11/21/2025

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