Provider Demographics
NPI:1164527875
Name:INNOVEX MEDICAL DIAGNOSTICS
Entity Type:Organization
Organization Name:INNOVEX MEDICAL DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA ALTIERI
Authorized Official - Suffix:
Authorized Official - Credentials:BSRRT
Authorized Official - Phone:407-281-9477
Mailing Address - Street 1:3224 CURRY WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-7885
Mailing Address - Country:US
Mailing Address - Phone:407-281-9477
Mailing Address - Fax:407-281-9477
Practice Address - Street 1:3224 CURRY WOODS CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-7885
Practice Address - Country:US
Practice Address - Phone:407-281-9477
Practice Address - Fax:407-281-9477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty