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General NPI Number Information
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NPI Number | 1932723699
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Entity Type | Organization
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Legal Business Name | CITYWIDE MEDICAL LAB LLC
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Dates
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Enumeration Date | 05/28/2020
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 1000 PARK CENTRE BLVD STE 150
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-5352
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Country | US
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Telephone | 305-768-9695
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Fax | 305-768-9698
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Provider Business Mailing Address
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Address Line | 1000 PARK CENTRE BLVD STE 150
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-5352
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Country | US
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Telephone | 305-768-9695
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Fax | 305-768-9698
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Authorized Official
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Title or Position | OWNER
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Name | NATALYA BILIK
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Credential |
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Telephone | 305-768-9695
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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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