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General NPI Number Information
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NPI Number | 1659794766
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Entity Type | Organization
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Legal Business Name | NEW FOUND LIFE OF DELRAY BEACH
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Dates
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Enumeration Date | 01/24/2014
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Last Update Date | 01/24/2014
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Provider Practice Location Address
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Address Line | 223 NE 5TH AVE SUITE 103-104
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City | DELRAY BEACH
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State | FL
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Zip | 33483-5530
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Country | US
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Telephone | 561-270-2361
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Fax | 561-270-2081
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Provider Business Mailing Address
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Address Line | 210 NE 6TH AVE 103-104
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City | DELRAY BEACH
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State | FL
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Zip | 33483-5540
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BIRECTOR OF BILLING
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Name | ANGELA IACULLO
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Credential |
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Telephone | 561-270-2361
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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 | 800027026
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License Number State | FL
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