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General NPI Number Information
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NPI Number | 1699216176
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Entity Type | Organization
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Legal Business Name | QUANTUM EXPOSURE
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Dates
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Enumeration Date | 03/16/2017
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 3180 S OCEAN DR SUITE 1105
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-7255
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Country | US
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Telephone | 800-214-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 3180 S OCEAN DR SUITE 1105
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-7255
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Country | US
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Telephone | 800-214-4001
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH A RESTREPO
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Credential | CLS, EMT
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Telephone | 800-214-4001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 594896919
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License Number State | FL
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