Provider Demographics
NPI:1316367790
Name:NATIONAL SYNAPSE DIAGNOSTIC SERVICES INC
Entity Type:Organization
Organization Name:NATIONAL SYNAPSE DIAGNOSTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ROBERTO
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RCA, R NCS T, R EDT
Authorized Official - Phone:305-494-1049
Mailing Address - Street 1:1135 PASADENA AVE S
Mailing Address - Street 2:223
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:FL
Mailing Address - Zip Code:33707-2887
Mailing Address - Country:US
Mailing Address - Phone:305-494-1049
Mailing Address - Fax:
Practice Address - Street 1:1135 PASADENA AVE S
Practice Address - Street 2:223
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-2887
Practice Address - Country:US
Practice Address - Phone:305-494-1049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRCA10346293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory