# E.M. EXOTIC HAIR CREATION & SUPPLY INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043749518
- **Authorized official:** MS. EVELYN METELLUS HAIR LOSS SPECIALIST (PRESIDENT)
- **Authorized official phone:** (561) 574-0597

## Contact information

- **Practice address:** 10300 FOREST HILL BLVD STE 270, WELLINGTON, FL 33414-3130
- **Practice address phone:** (561) 200-2820
- **Mailing address:** 10300 FOREST HILL BLVD, WELLINGTON, FL 33414-3120
- **Mailing address phone:** (561) 200-2820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1744P3200X | Prosthetics Case Management | CE10000534 | FL | Yes |

## Other

- **Enumeration date:** 06/08/2017
- **Last updated:** 06/07/2026