Healthcare Provider Details

I. General information

NPI: 1134190564
Provider Name (Legal Business Name): GLOBAL PATHOLOGY LABORATORY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16250 NW 59TH AVE #201
MIAMI LAKES FL
33014-7542
US

IV. Provider business mailing address

16250 NW 59TH AVE #201
MIAMI LAKES FL
33014-7542
US

V. Phone/Fax

Practice location:
  • Phone: 305-825-4422
  • Fax:
Mailing address:
  • Phone: 305-825-4422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW J HANLY
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 305-825-4422