The Mannequin Queen LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

THE MANNEQUIN QUEEN LLC

Practice address

3614 Chios Island Rd Apt 203
Seffner, FL 33584-8377

Phone

(813) 928-1248

Fax

(813) 999-4857

NPI assigned

Jul 15, 2021

Organization subpart

No

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

Authorized official

Name

Lakeesha S James

Title

Owner

Phone

(813) 928-1248

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1669044905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3614 CHIOS ISLAND RD APT 203",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "335848377",
            "telephone_number": "813-928-1248",
            "fax_number": "813-999-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 CHIOS ISLAND RD APT 203",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "335848377",
            "telephone_number": "813-928-1248",
            "fax_number": "813-999-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MANNEQUIN QUEEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "LAKEESHA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-928-1248"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marian Torres Alvarez
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• Prosthetic/Orthotic Supplier in Seffner, FL
• Providers in Seffner, 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 Jul 15, 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.