Provider Demographics
NPI:1073610275
Name:FLOW PATH LABORATORIES INC
Entity Type:Organization
Organization Name:FLOW PATH LABORATORIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HIRSCHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-491-8035
Mailing Address - Street 1:PO BOX 63069
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29419-3069
Mailing Address - Country:US
Mailing Address - Phone:866-759-4528
Mailing Address - Fax:
Practice Address - Street 1:7449 SOUTH MILITARY TRAIL
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463
Practice Address - Country:US
Practice Address - Phone:305-229-4311
Practice Address - Fax:305-229-4388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10D1061166291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2773741-00Medicaid
FL99799OtherBLUE CROSS BLUE SHIELD
FL2773741-00Medicaid