Individual
ANTAKEISHA LAVONTE HEPBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASTER WIG ARTIST
Contact information
Practice address
2326 NW 51ST ST, MIAMI, FL 33142-3677
(786) 291-7808
Mailing address
2326 NW 51ST ST, MIAMI, FL 33142-3677
(786) 291-7808
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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