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General NPI Number Information
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NPI Number | 1376090399
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Entity Type | Organization
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Legal Business Name | BB LABS
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 09/07/2016
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Provider Practice Location Address
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Address Line | 812 SW 3RD CT
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City | DELRAY BEACH
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State | FL
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Zip | 33444-4435
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Country | US
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Telephone | 754-366-7192
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Fax |
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Provider Business Mailing Address
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Address Line | 2002 20TH LN
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City | GREENACRES
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State | FL
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Zip | 33463-4259
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Country | US
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Telephone | 754-366-7192
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | ANTOINE JACQUES
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Credential |
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Telephone | 754-366-7192
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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 | 10D2115859
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License Number State | FL
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