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Contact Information

CUSTOM CROWNS
5400 S UNIVERSITY DR
DAVIE, FL33328-5312
 Phone: 954-947-0641
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical Laboratory

246RM2200X
 

Clinic/Center

261Q00000X
 

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
 

Community Health

261QC1500X
 

Developmental - Behavioral Pediatrics

2080P0006X 37 Physician/Pediatric Medicine
 

Health Service

261QH0100X
 

Infusion Therapy

261QI0500X
 

Mental Health (Including Community Mental Health Center)

261QM0801X B4[14] Community Mental Health Center
 

Multi-Specialty

261QM1300X 70 Clinic or Group Practice
 

Occupational Medicine

261QX0100X
Indicates primary specialty

NPI Profile & details for CUSTOM CROWNS · (Female)

NPI Number 1538813910
Status Active
Credentials
Entity Individual
Enumeration date 02/04/2022
Last updated 02/04/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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