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Lifeshapes Boutique Inc
Prosthetic/Orthotic Supplier in Brandon, Florida
NPI 1316047350

Lifeshapes Boutique Inc is a Prosthetic/Orthotic Supplier based in Brandon, FL. Lifeshapes Boutique Inc practices in Brandon, FL. The NPI Number for Lifeshapes Boutique Inc is 1316047350 and holds a License No. (Florida).

The current practice location address for Lifeshapes Boutique Inc is 518 Lakewood Dr, Brandon, FL and can be reached out via phone at 813-654-6968 and via fax at 813-655-6968.

Location: 518 Lakewood Dr, Brandon, FL, 33510-4037
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1316047350
Provider Name
Lifeshapes Boutique Inc
Credential
Provider Entity Type
Organization
Address
518 Lakewood Dr, Brandon, FL, 33510-4037
Phone Number
813-654-6968
Fax Number
813-655-6968
Provider Enumeration Date
09/22/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
M2444 01 FL BCBS
institution
Provider Business Practice Location Address Details
Address
518 Lakewood Dr
City
Brandon
State
Florida
Zip
33510-4037
Phone Number
813-654-6968
Fax Number
813-655-6968
person
Provider Business Mailing Address Details
Address
518 Lakewood Dr
City
Brandon
State
Florida
Zip
33510-4037
Phone Number
813-654-6968
Fax Number
813-655-6968
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
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.
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