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General NPI Number Information
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NPI Number | 1457195109
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Entity Type | Organization
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Legal Business Name | PATHOLOGY NETWORK LLC
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Dates
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Enumeration Date | 06/19/2024
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 160 SW 12TH AVE STE 103C
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-3119
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Country | US
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Telephone | 561-507-0522
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Fax | 561-431-2922
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Provider Business Mailing Address
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Address Line | 160 SW 12TH AVE STE 103C
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-3119
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Country | US
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Telephone | 561-507-0522
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Fax | 561-431-2922
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ANNA DZEVA
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Credential |
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Telephone | 561-507-0522
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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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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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