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General NPI Number Information
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NPI Number | 1477670776
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA PATHOLOGY LABORATORY
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 11400 OVERSEAS HWY 209
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City | MARATHON
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State | FL
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Zip | 33050-3600
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Country | US
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Telephone | 954-370-1053
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 17347
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City | PLANTATION
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State | FL
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Zip | 33318-7347
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Country | US
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Telephone | 954-370-1053
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | ZHIMING LI
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Credential |
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Telephone | 954-370-1053
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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 | FL
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