Provider Demographics
NPI:1316492002
Name:FLORIDA HOME HEALTH'S PINK RIBBON BOUTIQUE
Entity type:Organization
Organization Name:FLORIDA HOME HEALTH'S PINK RIBBON BOUTIQUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FARO
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-843-2777
Mailing Address - Street 1:4700 L B MCLEOD RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-6422
Mailing Address - Country:US
Mailing Address - Phone:407-843-2777
Mailing Address - Fax:407-843-5545
Practice Address - Street 1:22 W UNDERWOOD ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1110
Practice Address - Country:US
Practice Address - Phone:407-843-2777
Practice Address - Fax:407-843-5545
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA HOME HEALTH EQUIPMENT AND SUPPLIES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies