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General NPI Number Information
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NPI Number | 1104746494
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Entity Type | Organization
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Legal Business Name | FAST & EASY MOBILE LAB LLC
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Dates
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Enumeration Date | 07/17/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 1988 SW MONTERREY LN
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-2027
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Country | US
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Telephone | 561-781-5008
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Fax |
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Provider Business Mailing Address
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Address Line | 1825 NW CORPORATE BLVD STE 110
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City | BOCA RATON
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State | FL
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Zip | 33431-8554
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Country | US
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Telephone | 561-718-5008
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Fax | 954-994-2759
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Authorized Official
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Title or Position | OWNER
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Name | MANOUCHEKA EVARISTE
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Credential |
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Telephone | 561-718-5008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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