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General NPI Number Information
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NPI Number | 1558894055
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Entity Type | Organization
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Legal Business Name | PHLEBLOGIC, LLC
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5962 SW 66TH TER
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-3520
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Country | US
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Telephone | 305-330-7679
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Fax | 855-464-1198
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Provider Business Mailing Address
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Address Line | 5962 SW 66TH TER
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-3520
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Country | US
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Telephone | 305-330-7679
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Fax | 855-464-1198
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Authorized Official
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Title or Position | PRESIDENT
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Name | YOHANNA CABRERA
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Credential |
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Telephone | 305-330-7679
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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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