Provider Demographics
NPI:1376291583
Name:FLORIDA'S MOBILE LAB
Entity Type:Organization
Organization Name:FLORIDA'S MOBILE LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAGDALA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-297-6119
Mailing Address - Street 1:PO BOX 611181
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33261-1181
Mailing Address - Country:US
Mailing Address - Phone:954-297-6119
Mailing Address - Fax:
Practice Address - Street 1:2070 LINCOLN AVE APT 5
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-5201
Practice Address - Country:US
Practice Address - Phone:954-297-6119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory