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General NPI Number Information
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NPI Number | 1851670889
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Entity Type | Organization
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Legal Business Name | ROLLING OAKS CYTOPATHOLOGY CONSULTANTS
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Dates
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Enumeration Date | 08/08/2011
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 1490 W 49TH PL STE 540
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City | HIALEAH
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State | FL
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Zip | 33012-8134
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Country | US
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Telephone | 954-892-4602
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Fax | 888-473-3515
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Provider Business Mailing Address
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Address Line | 18200 SW 52ND CT
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City | SOUTHWEST RANCHES
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State | FL
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Zip | 33331-2239
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Country | US
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Telephone | 954-892-4602
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Fax |
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | MR. CARLOS A LOVERA
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Credential | CT
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Telephone | 954-892-4605
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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 | 800026079
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License Number State | FL
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