MEDICARE: SEACOAST PATHOLOGY INC

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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1790996882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEACOAST PATHOLOGY INC

Provider Business Mailing Address
First Line	:	11025 RCA CENTER DRIVE
Second Line	:	SUITE 300
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4269
Country	:	US
Telephone Number	:	561-626-5512
Fax Number	:	561-626-4530

Provider Business Practice Location Address
First Line	:	1 HAMPTON RD UNIT 307
Second Line	:
City	:	EXETER
State	:	NH
Zip	:	03833-4849
Country	:	US
Telephone Number	:	603-778-8522
Fax Number	:	603-778-1602

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DINA VALLADARES
Credential	:
Telephone Number	:	561-514-5822

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	06/24/2025

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