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General NPI Number Information
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NPI Number | 1528653334
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Entity Type | Organization
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Legal Business Name | RELIANCE DIAGNOSTICS LLC
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 12930 SW 128TH ST STE 102
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City | MIAMI
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State | FL
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Zip | 33186-6038
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Country | US
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Telephone | 786-701-8628
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Fax | 305-489-7983
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Provider Business Mailing Address
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Address Line | 12930 SW 128TH ST STE 102
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City | MIAMI
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State | FL
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Zip | 33186-6038
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Country | US
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Telephone | 786-701-8628
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Fax | 305-489-7983
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | KAREN AVERY
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Credential |
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Telephone | 702-830-3009
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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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