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General NPI Number Information
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NPI Number | 1164527875
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Entity Type | Organization
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Legal Business Name | INNOVEX MEDICAL DIAGNOSTICS
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3224 CURRY WOODS CIR
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City | ORLANDO
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State | FL
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Zip | 32822-7885
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Country | US
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Telephone | 407-281-9477
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Fax | 407-281-9477
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Provider Business Mailing Address
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Address Line | 3224 CURRY WOODS CIR
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City | ORLANDO
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State | FL
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Zip | 32822-7885
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Country | US
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Telephone | 407-281-9477
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Fax | 407-281-9477
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Authorized Official
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Title or Position | MANAGER
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Name | MR. FRANK RIVERA ALTIERI
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Credential | BS.RRT
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Telephone | 407-281-9477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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