Provider Demographics
NPI:1043762818
Name:FIDELITY DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:FIDELITY DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STELIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:FINDRILAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-220-5009
Mailing Address - Street 1:1701 GREEN ROAD
Mailing Address - Street 2:SUITE A3
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1701 GREEN ROAD
Practice Address - Street 2:SUITE A3
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064
Practice Address - Country:US
Practice Address - Phone:954-350-0104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory