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General NPI Number Information
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NPI Number | 1619080009
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Entity Type | Organization
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Legal Business Name | AMERICAN DERMPATH SPECIALISTS INC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 11/14/2008
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Provider Practice Location Address
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Address Line | 8130 ROYAL PALM BLVD SUITE 201
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5703
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Country | US
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Telephone | 954-232-9479
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Fax | 954-421-3201
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Provider Business Mailing Address
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Address Line | 8130 ROYAL PALM BLVD SUITE 201
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5703
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Country | US
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Telephone | 954-232-9479
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Fax | 954-421-3201
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MICHELLE SCHLECKER
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Credential |
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Telephone | 954-421-3200
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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 | 10D1023742
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License Number State | FL
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