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General NPI Number Information
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NPI Number | 1720800188
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Entity Type | Organization
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Legal Business Name | PRECISION UNLIMITED DIAGNOSTICS INC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 450 FAIRWAY DR STE 103
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-1837
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Country | US
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Telephone | 954-379-8316
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Fax | 954-889-7834
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Provider Business Mailing Address
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Address Line | 450 FAIRWAY DR STE 103
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-1837
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Country | US
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Telephone | 954-379-8316
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Fax | 954-889-7834
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Authorized Official
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Title or Position | OWNER
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Name | CONSTANCE GOVERNALE
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Credential |
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Telephone | 954-663-0040
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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 |
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License Number State |
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