Organization
PARADISE LLC
Active
Organization
PARADISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BORIS SMORODA (MANAGER)
(720) 220-1377
Entity
Organization
Contact information
Practice address
10691 E BETHANY DR, UNIT 900, AURORA, CO 80014-2643
(720) 220-1377
Mailing address
10691 E BETHANY DR, UNIT 900, AURORA, CO 80014-2643
(720) 220-1377
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38776561
—
CO
05
—
96507080
—
CO
Enumeration date
09/14/2009
Last updated
09/14/2009
Update your record
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