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General NPI Number Information
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NPI Number | 1629176466
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Entity Type | Organization
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Legal Business Name | BIOHEALTH MEDICAL LABORATORY INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 3399 NW 72ND AVE SUITE #222
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City | MIAMI
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State | FL
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Zip | 33122-1349
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Country | US
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Telephone | 305-436-1413
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Fax | 305-436-1447
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Provider Business Mailing Address
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Address Line | 3399 NW 72ND AVE SUITE #222
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City | MIAMI
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State | FL
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Zip | 33122-1349
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Country | US
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Telephone | 305-436-1413
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Fax | 305-436-1447
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Authorized Official
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Title or Position | C.E.O.
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Name | SRI BHARAT MADIREDDY
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Credential | PH.D.
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Telephone | 561-249-4317
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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 | 800019628
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License Number State | FL
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