Phive Star Hair Boutique LLC

Primary specialty

ProsthetistTaxonomy code 224P00000X

Legal business name

PHIVE STAR HAIR BOUTIQUE LLC

Doing business as

Phive Star Hair Boutique LLC

Practice address

320 N Magnolia Ave Ste A1
Orlando, FL 32801-1650

Phone

(321) 374-1460

NPI assigned

Aug 17, 2022

Organization subpart

No

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

Authorized official

Name

Kateau Cerisme

Title

Ceo

Phone

(321) 374-1460

Specialties & licenses 1

Addresses

Other names 1

• Phive Star Hair Boutique LLC Doing business as

Locations

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1467170324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N MAGNOLIA AVE STE A1",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011650",
            "telephone_number": "321-374-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N MAGNOLIA AVE STE A1",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011650",
            "telephone_number": "321-374-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHIVE STAR HAIR BOUTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-17",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "CERISME",
        "authorized_official_first_name": "KATEAU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-374-1460"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phive Star Hair Boutique LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetist in Orlando, FL
• Providers in Orlando, FL by specialty
• Prosthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.