Provider Demographics
NPI:1447930177
Name:ARTISTREE, LLC
Entity type:Organization
Organization Name:ARTISTREE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WINNIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-866-0054
Mailing Address - Street 1:7575 DR PHILLIPS BLVD STE 155
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7220
Mailing Address - Country:US
Mailing Address - Phone:407-982-4876
Mailing Address - Fax:407-650-2754
Practice Address - Street 1:335 KENMORE AVE STE 200
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4167
Practice Address - Country:US
Practice Address - Phone:443-866-0054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty