Provider Demographics
NPI:1679349328
Name:KEELA ESSENTIAL LLC
Entity type:Organization
Organization Name:KEELA ESSENTIAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEQUILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST CE
Authorized Official - Phone:954-588-2557
Mailing Address - Street 1:7191 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-1050
Mailing Address - Country:US
Mailing Address - Phone:954-588-2557
Mailing Address - Fax:954-807-3870
Practice Address - Street 1:7191 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-1050
Practice Address - Country:US
Practice Address - Phone:954-588-2557
Practice Address - Fax:954-807-3870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty