Provider Demographics
NPI:1629042981
Name:THE MEDITREND GROUP, INC.
Entity Type:Organization
Organization Name:THE MEDITREND GROUP, INC.
Other - Org Name:MEDITREND CONSULTANTS, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-633-1008
Mailing Address - Street 1:2030 W MCNAB RD
Mailing Address - Street 2:STE 2
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1002
Mailing Address - Country:US
Mailing Address - Phone:954-633-1000
Mailing Address - Fax:954-633-1024
Practice Address - Street 1:2030 W MCNAB RD
Practice Address - Street 2:STE 2
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1002
Practice Address - Country:US
Practice Address - Phone:954-633-1000
Practice Address - Fax:954-633-1024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL8490Medicare PIN