Organization
APPLIED LIGHTING INC
Active
Other names
The Pink Door
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN DETAR CFM (PRESIDENT)
(386) 328-9424
Entity
Organization
Contact information
Practice address
101 SUNSET PT, PALATKA, FL 32177-9018
(386) 328-9424
(386) 328-9470
Mailing address
101 SUNSET PT, PALATKA, FL 32177-9018
(386) 328-9424
(386) 328-9470
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M2732
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/01/2006
Last updated
03/29/2023
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