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General NPI Number Information
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NPI Number | 1114976784
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Entity Type | Organization
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Legal Business Name | MARBE LABS
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6303 SW 116TH PL
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City | MIAMI
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State | FL
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Zip | 33173-4796
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Country | US
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Telephone | 305-989-3793
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Fax | 305-271-8074
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Provider Business Mailing Address
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Address Line | 6303 SW 116TH PL
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City | MIAMI
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State | FL
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Zip | 33173-4770
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Country | US
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Telephone | 305-989-3793
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Fax | 305-271-8074
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Authorized Official
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Title or Position | PRESIDENT
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Name | AURA L IVANOFF
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Credential |
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Telephone | 305-989-3793
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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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