Organization
FABULOUSLY MADE SALON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNA Y AMARANTE (HAIR LOSS SPECIALIST)
(813) 444-3229
Entity
Organization
Contact information
Practice address
8909 REGENTS PARK DR STE 415, TAMPA, FL 33647-3432
(813) 444-3229
Mailing address
8909 REGENTS PARK DR STE 415, TAMPA, FL 33647-3432
(813) 444-3229
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
03/14/2018
Last updated
01/14/2026
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