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General NPI Number Information
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NPI Number | 1396033593
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Entity Type | Organization
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Legal Business Name | NATIVE AMERICAN DIAGNOSTICS LLC
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Dates
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Enumeration Date | 07/21/2011
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Last Update Date | 07/21/2011
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Provider Practice Location Address
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Address Line | 2771 SW 81ST WAY
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City | DAVIE
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State | FL
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Zip | 33328-1617
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Country | US
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Telephone | 305-555-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 2771 SW 81ST WAY
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City | DAVIE
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State | FL
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Zip | 33328-1617
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | ERNEST TIGER
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Credential |
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Telephone | 305-555-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State | FL
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