Healthcare Provider Details

I. General information

NPI: 1245738228
Provider Name (Legal Business Name): EXAM SOLUTIONS LAB SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 S DIXIE HWY STE 205E
MIAMI FL
33133-2463
US

IV. Provider business mailing address

10963 SW 124TH RD
MIAMI FL
33176-4544
US

V. Phone/Fax

Practice location:
  • Phone: 786-860-4647
  • Fax:
Mailing address:
  • Phone: 787-863-2411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number StateFL

VIII. Authorized Official

Name: ELIZABETH M MESEGUE
Title or Position: PRESIDENT
Credential: MBA
Phone: 786-863-2411