CUSTOM CROWNS – NPI #1538813910
Technician, Pathology

CUSTOM CROWNS is a pathology technician located in DAVIE, FL. NPPES has assigned the NPI number 1538813910 to CUSTOM CROWNS on February 04, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 246RM2200X from the Health Care Provider Taxonomy code set, which is classified as Technician, Pathology, specializing in Medical Laboratory Keep in mind, having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CUSTOM CROWNS below.

NPI Profile for
CUSTOM CROWNS

NPI Number
1538813910
Enumeration Date

(more than 4 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CUSTOM CROWNS
Primary location
5400 S UNIVERSITY DR
DAVIE, FL 33328-5312
Phone: (954) 947-0641 Fax:
Mailing address
5202 PLUNKETT ST
HOLLYWOOD, FL 33021-8023
Phone: (305) 788-7779 Fax:
Organization Subpart
No
Authorized Official
TYSHAWN MARTIN
CEO
Phone: (305) 788-7779
Updated
Certification Date
Feb 04, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
246RM2200X
- Technician, Pathology / Medical Laboratory (Primary)
291U00000X
- Clinical Medical Laboratory
261QX0100X
- Clinic/Center / Occupational Medicine
261QM1300X
- Clinic/Center / Multi-Specialty
261QM0801X
- Clinic/Center / Mental Health (Including Community Mental Health Center)
261QI0500X
- Clinic/Center / Infusion Therapy
261QH0100X
- Clinic/Center / Health Service
261QC1500X
- Clinic/Center / Community Health
261Q00000X
- Clinic/Center
247ZC0005X
- Technician, Pathology / Clinical Laboratory Director, Non-physician
2080P0006X
- Pediatrics / Developmental - Behavioral Pediatrics

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
G-SUITE
Content Type
CSV
Affiliation
N
Endpoint Location
5400 S UNIVERSITY DR,
DAVIE, FL 77025-1669