Organization
UNBREAKABLE GODDESS BY SHAKEENA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAKEENA JACKSON (OWNER)
(727) 831-4746
Entity
Organization
Contact information
Practice address
609 MINNESOTA DR, CLEARWATER, FL 33755-2540
(727) 831-4746
Mailing address
1OO SOUTH BELCHER ROAD, #7413, CLEARWATER, FL 33758
(727) 831-4746
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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