# YBOR CITY ELITE SALON

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

## Provider details

- **NPI number:** 1609375856
- **Authorized official:** DONETTE KERR HAIR LOSS (MANAGER)
- **Authorized official phone:** (813) 503-0882

## Contact information

- **Practice address:** 1910 E 7TH AVE STE 102, TAMPA, FL 33605-3810
- **Practice address phone:** (813) 503-0882
- **Mailing address:** 1910 E 7TH AVE STE 102, TAMPA, FL 33605-3810
- **Mailing address phone:** (813) 503-0882

## Taxonomy

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

## Other

- **Enumeration date:** 02/02/2018
- **Last updated:** 07/21/2022