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General NPI Number Information
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NPI Number | 1194099762
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Entity Type | Organization
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Legal Business Name | DOCTORS CLINICAL LABORATORY SERVICES INC.
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 8280 NW 27TH ST STE 501
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City | DORAL
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State | FL
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Zip | 33122-1905
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Country | US
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Telephone | 305-597-9905
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Fax |
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Provider Business Mailing Address
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Address Line | 8280 NW 27TH ST STE 501
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City | DORAL
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State | FL
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Zip | 33122-1905
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Country | US
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Telephone | 305-597-9905
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RAFAEL BENITEZ
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Credential |
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Telephone | 305-597-9905
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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 | 800026333
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License Number State | FL
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