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General NPI Number Information
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NPI Number | 1144729575
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Entity Type | Organization
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Legal Business Name | LABS AT YOUR DOOR LLC
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 02/12/2018
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Provider Practice Location Address
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Address Line | 4612 N HIATUS RD
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City | SUNRISE
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State | FL
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Zip | 33351-7909
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Country | US
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Telephone | 954-643-4105
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Fax | 866-768-4708
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Provider Business Mailing Address
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Address Line | 4612 N HIATUS RD
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City | SUNRISE
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State | FL
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Zip | 33351-7909
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATSY MCCOARD
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Credential |
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Telephone | 954-643-4105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number |
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License Number State |
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