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NPI Code Detail

MEDICARE: NEW FOUND LIFE OF DELRAY BEACH

MEDICARE: NEW FOUND LIFE OF DELRAY BEACH
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
1291U00000XClinical Medical Laboratory800027026FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1800027026OTHERFLAGENCY FOR HEALTH CARE ADMINISTRATION
210D2035690OTHERFLCLIA

General Provider Information

NPI Number : 1659794766
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW FOUND LIFE OF DELRAY BEACH
Provider Business Mailing Address
First Line : 210 NE 6TH AVE
Second Line : 103-104
City : DELRAY BEACH
State : FL
Zip : 33483-5540
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 223 NE 5TH AVE
Second Line : SUITE 103-104
City : DELRAY BEACH
State : FL
Zip : 33483-5530
Country : US
Telephone Number : 561-270-2361
Fax Number : 561-270-2081
Authorized Official
Title or Position : BIRECTOR OF BILLING
Name : ANGELA IACULLO
Credential :
Telephone Number : 561-270-2361
Provider Enumeration Date : 01/24/2014
Last Update Date : 01/24/2014

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Directions to “NEW FOUND LIFE OF DELRAY BEACH ” Practice Location

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