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General NPI Number Information
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NPI Number | 1760242960
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Entity Type | Organization
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Legal Business Name | NEXTGEN PATHOLOGY
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 13695 US HIGHWAY 1
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City | SEBASTIAN
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State | FL
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Zip | 32958-3230
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Country | US
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Telephone | 772-589-3186
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 526845
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City | MIAMI
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State | FL
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Zip | 33152-6845
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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 | OWNER
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Name | HADI YAZIJI
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Credential |
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Telephone | 305-267-7979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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