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NPI Code Detail

MEDICARE: MED LAB OF SOUTH FLORIDA

MEDICARE: MED LAB OF SOUTH FLORIDA
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 LaboratoryFL

General Provider Information

NPI Number : 1669503686
Entity Type Code : Organization
Provider Name (Legal Business Name) : MED LAB OF SOUTH FLORIDA
Provider Business Mailing Address
First Line : 999 SW 71ST AVE
Second Line :
City : NORTH LAUDERDALE
State : FL
Zip : 33068-2313
Country : US
Telephone Number : 954-722-8577
Fax Number : 954-720-1666
Provider Business Practice Location Address
First Line : 999 SW 71ST AVE
Second Line :
City : NORTH LAUDERDALE
State : FL
Zip : 33068-2313
Country : US
Telephone Number : 954-722-8577
Fax Number : 954-720-1666
Authorized Official
Title or Position : VICE PRESIDENT
Name : LOURDES ELOI
Credential :
Telephone Number : 954-722-8577
Provider Enumeration Date : 03/08/2007
Last Update Date : 07/18/2007

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Directions to “MED LAB OF SOUTH FLORIDA ” Practice Location

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