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General NPI Number Information
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NPI Number | 1164813275
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Entity Type | Organization
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Legal Business Name | ONYX MEDICAL CENTER, CORP
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Dates
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Enumeration Date | 02/11/2015
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Last Update Date | 07/12/2016
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Provider Practice Location Address
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Address Line | 9900 W SAMPLE RD STE 310
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4048
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Country | US
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Telephone | 954-459-4097
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Fax |
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Provider Business Mailing Address
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Address Line | 3280 NW 103RD TER
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-6102
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Country | US
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Telephone | 954-459-4097
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHENICKEA GODFREY
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Credential |
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Telephone | 954-510-6890
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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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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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