MEDICARE: ACCURATE PATHOLOGY SERVICES MD PL

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568036713
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCURATE PATHOLOGY SERVICES MD PL

Provider Business Mailing Address
First Line	:	PO BOX 742515
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-2515
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2521 DEL PRADO BLVD N
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-4003
Country	:	US
Telephone Number	:	863-419-2497
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FERNANDO LUIS LOMBA
Credential	:
Telephone Number	:	941-766-4120

Provider Enumeration Date	:	05/13/2021
Last Update Date	:	05/13/2021

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