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General NPI Number Information
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NPI Number | 1639466063
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Entity Type | Organization
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Legal Business Name | ANY LAB TEST FAST
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 14055 WEST DIXIE
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City | NORTH MIAMI
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State | FL
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Zip | 33161-3442
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Country | US
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Telephone | 305-456-3317
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Fax | 305-456-9219
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Provider Business Mailing Address
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Address Line | 14055 WEST DIXIE
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City | NORTH MIAMI
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State | FL
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Zip | 33161-3442
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Country | US
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Telephone | 305-456-3317
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Fax | 305-456-9219
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Authorized Official
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Title or Position | LABORATORY DIRECTOS/OWNER
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Name | MRS. ESTELA PINNAVARIA
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Credential |
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Telephone | 305-456-3317
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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 | 13-64-1351067
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License Number State | FL
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