MEDICARE: COVITEST

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	261QC1800X	Corporate Health Clinic/Center

General Provider Information

NPI Number	:	1699398891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COVITEST

Provider Business Mailing Address
First Line	:	3450 W 84TH ST STE 103A
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33018-4924
Country	:	US
Telephone Number	:	305-364-1218
Fax Number	:

Provider Business Practice Location Address
First Line	:	3450 W 84TH ST STE 103A
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33018-4924
Country	:	US
Telephone Number	:	305-364-1218
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARTHA KNOWLES
Credential	:
Telephone Number	:	305-364-1218

Provider Enumeration Date	:	05/21/2020
Last Update Date	:	05/21/2020

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Directions to “COVITEST ” Practice Location

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