Healthcare Provider Details

I. General information

NPI: 1306501028
Provider Name (Legal Business Name): PATHOLOGY CONSULTANTS OF SOUTH BROWARD, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 JO DIMAGGIO DRIVE
HOLLYWOOD FL
33021
US

IV. Provider business mailing address

9581 PREMIER PKWY
MIRAMAR FL
33025-3206
US

V. Phone/Fax

Practice location:
  • Phone: 954-276-1864
  • Fax:
Mailing address:
  • Phone: 954-276-1864
  • Fax: 954-967-7630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: ARTUR EDUARDO DE OLIVEIRA RANGEL FILHO
Title or Position: OWNER
Credential: MD
Phone: 954-276-1864