Healthcare Provider Details

I. General information

NPI: 1235515008
Provider Name (Legal Business Name): TOXICOLOGY LAB SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 01/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16855 NE 2ND AVE SUITE 101N
NORTH MIAMI BEACH FL
33162-1744
US

IV. Provider business mailing address

16855 NE 2ND AVE SUITE 101N
NORTH MIAMI BEACH FL
33162-1744
US

V. Phone/Fax

Practice location:
  • Phone: 305-944-1516
  • Fax: 888-510-9071
Mailing address:
  • Phone: 305-944-1516
  • Fax: 888-510-9071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LUISA TALENO
Title or Position: COO
Credential: MBA
Phone: 786-457-7014