Provider Demographics
NPI:1326211707
Name:QUALITY LAB OF FLORIDA, INC
Entity Type:Organization
Organization Name:QUALITY LAB OF FLORIDA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:F
Authorized Official - Last Name:MIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-348-4444
Mailing Address - Street 1:8571 LEATHERLEAF LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827
Mailing Address - Country:US
Mailing Address - Phone:407-348-4444
Mailing Address - Fax:407-344-4040
Practice Address - Street 1:325 WEST OAK STREET
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741
Practice Address - Country:US
Practice Address - Phone:407-348-4444
Practice Address - Fax:407-344-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291U00000X
FL800024962291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory