Provider Demographics
NPI:1679560601
Name:CRANIAL TECHNOLOGIES OF MIAMI INC
Entity type:Organization
Organization Name:CRANIAL TECHNOLOGIES OF MIAMI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:HERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:CLINICAL ORTHOTIST
Authorized Official - Phone:480-505-1840
Mailing Address - Street 1:1395 W AUTO DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1026
Mailing Address - Country:US
Mailing Address - Phone:480-505-1840
Mailing Address - Fax:480-505-1844
Practice Address - Street 1:1395 W AUTO DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1026
Practice Address - Country:US
Practice Address - Phone:480-505-1840
Practice Address - Fax:480-505-1844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier