MEDICARE: MANA DIAGNOSTICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1134058142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANA DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	6100 HOLLYWOOD BLVD
Second Line	:	SUITE 304
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024
Country	:	US
Telephone Number	:	678-730-0786
Fax Number	:

Provider Business Practice Location Address
First Line	:	6100 HOLLYWOOD BLVD
Second Line	:	SUITE 304
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024
Country	:	US
Telephone Number	:	678-730-0786
Fax Number	:

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	FRANCIS JUSTO
Credential	:
Telephone Number	:	786-650-8802

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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Directions to “MANA DIAGNOSTICS LLC ” Practice Location

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