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NPI Code Detail

MEDICARE: NEXTGEN PATHOLOGY

MEDICARE: NEXTGEN PATHOLOGY
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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician

Other Identifiers

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

General Provider Information

NPI Number : 1649998824
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEXTGEN PATHOLOGY
Provider Business Mailing Address
First Line : PO BOX 526845
Second Line :
City : MIAMI
State : FL
Zip : 33152-6845
Country : US
Telephone Number : 321-636-2211
Fax Number : 321-633-7085
Provider Business Practice Location Address
First Line : 110 LONGWOOD AVE
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-2828
Country : US
Telephone Number : 321-636-2211
Fax Number : 321-633-7085
Authorized Official
Title or Position : MEMBER
Name : HADI YAZIJI
Credential : MD
Telephone Number : 786-266-5725
Provider Enumeration Date : 08/15/2022
Last Update Date : 12/08/2025

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Directions to “NEXTGEN PATHOLOGY ” Practice Location

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