| NPI | 1538813910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYSHAWN MARTIN CEO 305-788-7779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246RM2200X Technician, Pathology Medical Laboratory |
| Additional Taxonomies | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics |
| 247ZC0005X Pathology Clinical Laboratory Director, Non-physician | |
| 261Q00000X Clinic/Center | |
| 261QC1500X Clinic/Center Community Health | |
| 261QH0100X Clinic/Center Health Service | |
| 261QI0500X Clinic/Center Infusion Therapy | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QX0100X Clinic/Center Occupational Medicine | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2022-02-04 |
| Last Update Date | 2022-02-04 |