Provider Demographics
NPI:1629469077
Name:SATORI WATERS, LLC
Entity Type:Organization
Organization Name:SATORI WATERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-256-8213
Mailing Address - Street 1:6831 NW 20TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1505
Mailing Address - Country:US
Mailing Address - Phone:954-256-8213
Mailing Address - Fax:954-256-8213
Practice Address - Street 1:6831 NW 20TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1505
Practice Address - Country:US
Practice Address - Phone:954-256-8213
Practice Address - Fax:954-256-8213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10D2068839291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory