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General NPI Number Information
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NPI Number | 1992823371
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Entity Type | Organization
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Legal Business Name | IMMUNO LABORATORIES OF FLORIDA, INC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 03/20/2013
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Provider Practice Location Address
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Address Line | 6801 POWERLINE RD
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-2155
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Country | US
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Telephone | 954-691-2500
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Fax | 954-691-2505
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Provider Business Mailing Address
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Address Line | 6801 POWERLINE RD
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-2155
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Country | US
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Telephone | 954-691-2500
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Fax | 954-691-2505
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CHERYL A ZAVIK
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Credential |
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Telephone | 954-691-2500
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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 | 800001454
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License Number State | FL
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