Custom Crowns
Custom Crowns is a Developmental - Behavioral Pediatrics Physician in Davie, Florida. Registered with an NPI since 2022.
- In the registry since
- 2022
- Specialties on file
- 11
Practice location Address checks out
5400 S University DrDavie, FL 33328-5312
Phone: (954) 947-0641
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Medical Laboratory Technician (primary) | Taxonomy 246RM2200X |
|---|---|
| Developmental - Behavioral Pediatrics Physician | Taxonomy 2080P0006X |
| Clinical Laboratory Director (Non-physician) | Taxonomy 247ZC0005X |
| Clinic/Center | Taxonomy 261Q00000X |
| Community Health Clinic/Center | Taxonomy 261QC1500X |
| Health Service Clinic/Center | Taxonomy 261QH0100X |
| Infusion Therapy Clinic/Center | Taxonomy 261QI0500X |
| Mental Health Clinic/Center (Including Community Mental Health Center) | Taxonomy 261QM0801X |
| Multi-Specialty Clinic/Center | Taxonomy 261QM1300X |
| Occupational Medicine Clinic/Center | Taxonomy 261QX0100X |
| Clinical Medical Laboratory | Taxonomy 291U00000X |
Record details
| NPI number | 1538813910 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Tyshawn Martin — Ceo · (305) 788-7779 |
| NPI enumerated | February 4, 2022 |
| Last updated in NPPES | February 4, 2022 |
| Certification date | February 4, 2022 |
| Mailing address | 5202 Plunkett St, Hollywood, FL 33021-8023 |
Other providers in Davie
-
Jayla Alexis Sheffield
5400 S University Dr Ste 502, Davie, FL 33328-5313 · (954) 764-9452