Healthcare Provider Details

I. General information

NPI: 1659922680
Provider Name (Legal Business Name): FIBRONOSTICS US, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 09/10/2021
Certification Date: 09/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3452 LAKE LYNDA DR STE 151
ORLANDO FL
32817-1472
US

IV. Provider business mailing address

1050 WALL ST W STE 360
LYNDHURST NJ
07071-3604
US

V. Phone/Fax

Practice location:
  • Phone: 888-552-1603
  • Fax: 321-256-6061
Mailing address:
  • Phone: 201-821-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: RONI H AMIEL
Title or Position: OWNER
Credential:
Phone: 888-552-1603