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General NPI Number Information
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NPI Number | 1154072221
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Entity Type | Organization
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Legal Business Name | ONX MANAGEMENT & TRUST LLC
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 300 SE 2ND ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-1923
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Country | US
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Telephone | 954-743-0830
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Fax |
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Provider Business Mailing Address
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Address Line | 451 SW 38TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-1878
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Country | US
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Telephone | 954-226-2421
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YOLANDA JEFFRIES
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Credential |
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Telephone | 954-226-2421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number |
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License Number State |
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