Provider Demographics
NPI:1518071869
Name:WORLD DIAGNOSTICS LABORATORY
Entity Type:Organization
Organization Name:WORLD DIAGNOSTICS LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:ZAYAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-585-0296
Mailing Address - Street 1:4111 SW 47TH AVE
Mailing Address - Street 2:SUITE 331
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-4026
Mailing Address - Country:US
Mailing Address - Phone:954-797-1662
Mailing Address - Fax:954-797-0367
Practice Address - Street 1:4111 SW 47TH AVE
Practice Address - Street 2:SUITE 331
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-4026
Practice Address - Country:US
Practice Address - Phone:954-797-1662
Practice Address - Fax:954-797-0367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
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
FLL9246Medicare ID - Type Unspecified