Provider Demographics
NPI:1710720248
Name:SKINALWAYSGLOWIN
Entity type:Organization
Organization Name:SKINALWAYSGLOWIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHMEADE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:407-412-8055
Mailing Address - Street 1:11954 NARCOOSSEE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6998
Mailing Address - Country:US
Mailing Address - Phone:407-768-2330
Mailing Address - Fax:
Practice Address - Street 1:10727 NARCOOSSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6943
Practice Address - Country:US
Practice Address - Phone:407-768-2330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care