Organization
A FITTING EXPERIENCE MASTECTOMY SHOPPE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH AGAMI (PRESIDENT/OWNER)
(954) 978-8287
Entity
Organization
Contact information
Practice address
2950 N STATE ROAD 7 STE 103, MARGATE, FL 33063-5748
(954) 978-8287
(954) 978-9059
Mailing address
2950 N STATE ROAD 7 STE 103, MARGATE, FL 33063-5748
(954) 978-8287
(954) 978-9059
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
1187390002
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
283302
AV-MED PROVIDER NUMBER
FL
01
—
9490689001
CIGNA PROVIDER
FL
01
—
M2420
BC/BS OF FLORIDA
FL
01
—
M2726
BC/BS OF FLORIDA-MARGATE
FL
Enumeration date
08/02/2005
Last updated
05/03/2024
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