Provider Demographics
NPI:1205231214
Name:ADVANCE BIOSOURCE
Entity Type:Organization
Organization Name:ADVANCE BIOSOURCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ZAMPARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-703-1689
Mailing Address - Street 1:8390 W FLAGLER ST
Mailing Address - Street 2:STE 208
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2039
Mailing Address - Country:US
Mailing Address - Phone:786-703-1689
Mailing Address - Fax:
Practice Address - Street 1:8390 W FLAGLER ST
Practice Address - Street 2:STE 208
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2039
Practice Address - Country:US
Practice Address - Phone:786-703-1689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory