Most Relevant Information
Provider Data
| NPI Number: | 1003689258 |
| Provider Name: | TINA-MARIE A LIBURD NAIL TECHNICIAN |
| Entity Type: | Individual |
| Taxonomy Code: | 374700000X |
| Specialty: | Technician |
| License Number: | FV9640664 |
Most Important Dates
| Enumeration Date: | 10/31/2023 |
| Last Updated: | 11/01/2023 |
Provider Practice Location
23138 RAINBOW RD
BOCA RATON
FL
334285620
Practice Location Phone/Fax
| Phone: | 9546964418 |
| Fax: |
Provider Mailing Location
PO BOX 8155
CORAL SPRINGS
FL
330758155
Provider Mailing Phone/Fax
| Phone: | 9546964418 |
| Fax: |