Provider Demographics
NPI:1851670889
Name:ROLLING OAKS CYTOPATHOLOGY CONSULTANTS
Entity Type:Organization
Organization Name:ROLLING OAKS CYTOPATHOLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOVERA
Authorized Official - Suffix:
Authorized Official - Credentials:CT
Authorized Official - Phone:954-892-4605
Mailing Address - Street 1:18200 SW 52ND CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33331-2239
Mailing Address - Country:US
Mailing Address - Phone:954-892-4602
Mailing Address - Fax:
Practice Address - Street 1:1490 W 49TH PL STE 540
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-8134
Practice Address - Country:US
Practice Address - Phone:954-892-4602
Practice Address - Fax:888-473-3515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-08
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800026079291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory