Provider Demographics
NPI:1942888672
Name:TITAN GENOMICS, LLC
Entity Type:Organization
Organization Name:TITAN GENOMICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ELAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-666-0815
Mailing Address - Street 1:1818 S AUSTRALIAN AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6447
Mailing Address - Country:US
Mailing Address - Phone:561-328-8639
Mailing Address - Fax:
Practice Address - Street 1:1818 S AUSTRALIAN AVE STE 410
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6447
Practice Address - Country:US
Practice Address - Phone:561-328-8639
Practice Address - Fax:561-617-9255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory