Preferred Performance LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PREFERRED PERFORMANCE LLC

Practice address

5002 22ND Ave S
Gulfport, FL 33707-4942

Phone

(727) 481-1152

Fax

(727) 481-1152

NPI assigned

Feb 2, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Irene Dacosta, COSMETOLOGIST

Title

Cosmetologist

Phone

(727) 481-1152

Specialties & licenses 1

Addresses

Electronic endpoints 2

Locations

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643760000000",
    "number": "1992458624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3135 1ST AVE N # 12735",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337309990",
            "telephone_number": "727-481-1152",
            "fax_number": "727-481-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 22ND AVE S",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337074942",
            "telephone_number": "727-481-1152",
            "fax_number": "727-481-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2021-12-30",
        "status": "A",
        "authorized_official_last_name": "DACOSTA",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "COSMETOLOGIST",
        "authorized_official_telephone_number": "727-481-1152",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "COSMETOLOGIST"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "7274811152",
            "affiliation": "N",
            "endpointDescription": "FAX",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "fax",
            "address_1": "5002 22nd Ave S",
            "city": "Gulfport",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337074942",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "7274811152",
            "affiliation": "N",
            "endpointDescription": "fax",
            "address_1": "5002 22nd Ave S",
            "city": "Gulfport",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337074942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Gulfport, FL
• Providers in Gulfport, 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 Feb 2, 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.