| NPI | 1003366188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GRATTENDICK CFO 561-626-5512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NV 1512LIC-14) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: NV 1512LIC-14) |
| 207ZH0000X Pathology, Hematology (Licence: NV 1512LIC-14) | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: NV 1512LIC-14) | |
| 207ZC0500X Pathology, Cytopathology (Licence: NV 1512LIC-14) | |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2022-08-26 |