Provider Demographics
NPI:1326331604
Name:PALMETTO PATHOLOGY SERVICES PA
Entity Type:Organization
Organization Name:PALMETTO PATHOLOGY SERVICES PA
Other - Org Name:FLORIDA PATHOLOGY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:LANCET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-822-6914
Mailing Address - Street 1:PO BOX 3093
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-0993
Mailing Address - Country:US
Mailing Address - Phone:305-822-6914
Mailing Address - Fax:305-822-2676
Practice Address - Street 1:8665 BIRD RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3215
Practice Address - Country:US
Practice Address - Phone:305-441-6845
Practice Address - Fax:305-461-6911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 14215207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty