Healthcare Provider Details

I. General information

NPI: 1619935855
Provider Name (Legal Business Name): ASAP DIAGNOSTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5913 JOHNSON ST
HOLLYWOOD FL
33021-5637
US

IV. Provider business mailing address

5913 JOHNSON ST
HOLLYWOOD FL
33021-5637
US

V. Phone/Fax

Practice location:
  • Phone: 954-893-3811
  • Fax: 954-893-3812
Mailing address:
  • Phone: 954-893-3811
  • Fax: 954-893-3812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License NumberHCC6581
License Number StateFL

VIII. Authorized Official

Name: MR. JULIAN A YEPE
Title or Position: PRESIDENT
Credential:
Phone: 954-893-3811