Healthcare Provider Details

I. General information

NPI: 1144147307
Provider Name (Legal Business Name): GUARDIAN DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 NW 2ND AVE STE 6
BOCA RATON FL
33431-4186
US

IV. Provider business mailing address

4800 NW 2ND AVE STE 6
BOCA RATON FL
33431-4186
US

V. Phone/Fax

Practice location:
  • Phone: 813-928-7939
  • Fax:
Mailing address:
  • Phone: 813-928-7939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SUE KINCER
Title or Position: BILLING MANGER
Credential:
Phone: 813-928-7939