Provider Demographics
NPI:1467469536
Name:CHARLES AIESI CONSULTING. INC.
Entity Type:Organization
Organization Name:CHARLES AIESI CONSULTING. INC.
Other - Org Name:BROWARD MEDICAL LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:AIESI
Authorized Official - Suffix:JR
Authorized Official - Credentials:TECHNICIAN
Authorized Official - Phone:954-739-7764
Mailing Address - Street 1:181 WEST PROSPECT ROAD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309
Mailing Address - Country:US
Mailing Address - Phone:954-739-7764
Mailing Address - Fax:954-739-7208
Practice Address - Street 1:181 WEST PROSPECT ROAD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309
Practice Address - Country:US
Practice Address - Phone:954-739-7764
Practice Address - Fax:954-739-7208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL8511Medicare ID - Type Unspecified