Organization
ADVANCED HEALTHY HAIR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNETTE TEASLEY (OWNER)
(407) 201-1518
Entity
Organization
Contact information
Practice address
2211 EDGEWATER DR STE 12, ORLANDO, FL 32804-5319
(407) 490-2990
Mailing address
8601 PISA DR APT 1425, ORLANDO, FL 32810-2153
(407) 201-1518
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019005700
—
FL
Enumeration date
09/23/2021
Last updated
09/23/2021
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