Provider Demographics
NPI:1477797553
Name:ELITE DIAGNOSTIX, INC.
Entity Type:Organization
Organization Name:ELITE DIAGNOSTIX, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-662-7181
Mailing Address - Street 1:2114 N FLAMINGO RD
Mailing Address - Street 2:SUITE 166
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-3501
Mailing Address - Country:US
Mailing Address - Phone:954-662-7181
Mailing Address - Fax:
Practice Address - Street 1:2114 N FLAMINGO RD
Practice Address - Street 2:SUITE 166
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-3501
Practice Address - Country:US
Practice Address - Phone:954-662-7181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty