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General NPI Number Information
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NPI Number | 1134646151
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Entity Type | Organization
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Legal Business Name | B & T DIAGNOSTICS LLC
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 05/18/2018
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Provider Practice Location Address
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Address Line | 11350 SW VILLAGE PKWY STE 323
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34987
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Country | US
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Telephone | 772-812-6852
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Fax | 772-494-7271
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Provider Business Mailing Address
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Address Line | 11350 SW VILLAGE PKWY STE 323
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34987-2352
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Country | US
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Telephone | 772-812-6852
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Fax | 772-494-7271
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Authorized Official
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Title or Position | MANAGER
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Name | LISA FLYNN
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Credential |
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Telephone | 772-812-6852
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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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