Healthcare Provider Details

I. General information

NPI: 1144993734
Provider Name (Legal Business Name): GRYFFIN'S TALON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 07/29/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 CORPORATE WAY STE 108
WEST PALM BCH FL
33407-2041
US

IV. Provider business mailing address

5601 CORPORATE WAY STE 108
WEST PALM BCH FL
33407-2041
US

V. Phone/Fax

Practice location:
  • Phone: 561-420-0010
  • Fax:
Mailing address:
  • Phone: 561-420-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRISTIAN MAYER
Title or Position: OWNER
Credential:
Phone: 561-420-0010