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General NPI Number Information
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NPI Number | 1730687708
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Entity Type | Organization
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Legal Business Name | AION PHLEBOTOMY
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 2321 NW 47TH AVE
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City | LAUDERHILL
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State | FL
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Zip | 33313-3544
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Country | US
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Telephone | 954-214-9235
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Fax |
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Provider Business Mailing Address
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Address Line | 2321 NW 47TH AVE
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City | LAUDERHILL
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State | FL
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Zip | 33313-3544
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Country | US
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Telephone | 954-214-9235
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Fax |
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Authorized Official
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Title or Position | MANGER
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Name | MR. ADONIS GIBSON
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Credential |
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Telephone | 954-214-9235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | 871051
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License Number State | FL
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