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General NPI Number Information
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NPI Number | 1376791129
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Entity Type | Organization
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Legal Business Name | ARIZONA PHYSICIAN'S LABORATORY, INC
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 6465 OVERSEAS HWY SUITE 8
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City | MARATHON
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State | FL
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Zip | 33050-2763
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Country | US
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Telephone | 305-289-0248
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Fax | 305-289-5461
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Provider Business Mailing Address
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Address Line | 6465 OVERSEAS HWY SUITE 8
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City | MARATHON
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State | FL
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Zip | 33050-2763
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Country | US
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Telephone | 305-289-0248
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Fax | 305-289-5461
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Authorized Official
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Title or Position | CEO
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Name | MISS DESIREE MONIQUE FELIX
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Credential |
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Telephone | 305-289-0248
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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 | PENDING
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License Number State | FL
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