1700133519 NPI number — NATIONAL CARE LABORATORIES LLC

Table of content: (NPI 1700133519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700133519 NPI number — NATIONAL CARE LABORATORIES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL CARE LABORATORIES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700133519
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2750 W 68TH ST
Provider Second Line Business Mailing Address:
SUITE 224-A
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33016-5446
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-414-2580
Provider Business Mailing Address Fax Number:
786-414-2581

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2750 W 68TH ST
Provider Second Line Business Practice Location Address:
224-A
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33016-5446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-414-2580
Provider Business Practice Location Address Fax Number:
786-414-2581
Provider Enumeration Date:
08/10/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LAMADRID
Authorized Official First Name:
ALBERTO
Authorized Official Middle Name:
ANTONIO
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
305-898-6289

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)