Forever Diaz Salon & Spa, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

FOREVER DIAZ SALON & SPA, LLC

Practice address

8237 Philadelphia Rd
Rosedale, MD 21237-2865

Phone

(410) 497-0782

NPI assigned

Apr 3, 2023

Last updated

Apr 3, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Candace Joy Diaz

Title

Ceo

Phone

(443) 854-3307

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1063117810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8237 PHILADELPHIA RD",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372865",
            "telephone_number": "410-497-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8237 PHILADELPHIA RD",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372865",
            "telephone_number": "410-497-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREVER DIAZ SALON & SPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-01",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-854-3307",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.