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General NPI Number Information
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NPI Number | 1396578969
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Entity Type | Organization
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Legal Business Name | BRIELLE DIAGNOSTICS LLC
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Dates
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Enumeration Date | 08/20/2024
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 3117 SPRING GLEN RD STE 402
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City | JACKSONVILLE
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State | FL
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Zip | 32207-5906
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Country | US
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Telephone | 904-977-5770
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Fax | 904-512-5352
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Provider Business Mailing Address
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Address Line | 3117 SPRING GLEN RD STE 402
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City | JACKSONVILLE
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State | FL
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Zip | 32207-5906
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Country | US
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Telephone | 904-977-5770
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Fax | 904-512-5352
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Authorized Official
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Title or Position | RHIT/OWNER
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Name | MONICA RENEE TRAMEL
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Credential |
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Telephone | 904-977-5770
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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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