Organization
ELEGANT BEAUTY SUPPLIES # 9 INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BASHIR MALOUF (DIRECTOR)
(305) 202-1224
Entity
Organization
Contact information
Practice address
2710 NW 135TH ST, OPA LOCKA, FL 33054-4856
(954) 921-9129
Mailing address
1209 S 30TH AVE, HOLLYWOOD, FL 33020-5631
(954) 921-9129
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/11/2013
Last updated
01/11/2013
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