Unbreakable Goddess by Shakeena LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

UNBREAKABLE GODDESS BY SHAKEENA LLC

Practice address

609 Minnesota Dr
Clearwater, FL 33755-2540

Phone

(727) 831-4746

NPI assigned

Dec 8, 2021

Organization subpart

No

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

Authorized official

Name

Shakeena Jackson

Title

Owner

Phone

(727) 831-4746

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1558029454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1OO SOUTH BELCHER ROAD",
            "address_2": "#7413",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33758",
            "telephone_number": "727-831-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 MINNESOTA DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337552540",
            "telephone_number": "727-831-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNBREAKABLE GODDESS BY SHAKEENA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SHAKEENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-831-4746"
    },
    "taxonomies": [
        {
            "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 Clearwater, FL
• Providers in Clearwater, FL by specialty
• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.