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General NPI Number Information
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NPI Number | 1578337408
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Entity Type | Organization
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Legal Business Name | COMPASS DIAGNOSTICS LLC
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 11/10/2023
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Provider Practice Location Address
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Address Line | 7457 103RD ST STE 5
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City | JACKSONVILLE
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State | FL
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Zip | 32210-6775
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Country | US
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Telephone | 904-219-2170
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Fax | 904-339-9418
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Provider Business Mailing Address
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Address Line | 7457 103RD ST STE 5
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City | JACKSONVILLE
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State | FL
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Zip | 32210-6775
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Country | US
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Telephone | 904-219-2170
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Fax | 904-339-9418
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Authorized Official
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Title or Position | OWNER
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Name | NELSON CRUZ
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Credential |
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Telephone | 904-219-2170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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