Healthcare Provider Details

I. General information

NPI: 1790996882
Provider Name (Legal Business Name): SEACOAST PATHOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HAMPTON RD UNIT 307
EXETER NH
03833-4849
US

IV. Provider business mailing address

11025 RCA CENTER DRIVE SUITE 300
PALM BEACH GARDENS FL
33410-4269
US

V. Phone/Fax

Practice location:
  • Phone: 603-778-8522
  • Fax: 603-778-1602
Mailing address:
  • Phone: 561-626-5512
  • Fax: 561-626-4530

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: DINA VALLADARES
Title or Position: DIRECTOR
Credential:
Phone: 561-514-5822