Provider Demographics
NPI:1134190564
Name:GLOBAL PATHOLOGY LABORATORY SERVICES INC
Entity type:Organization
Organization Name:GLOBAL PATHOLOGY LABORATORY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:HANLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-825-4422
Mailing Address - Street 1:16250 NW 59TH AVE
Mailing Address - Street 2:#201
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-7542
Mailing Address - Country:US
Mailing Address - Phone:305-825-4422
Mailing Address - Fax:
Practice Address - Street 1:16250 NW 59TH AVE
Practice Address - Street 2:#201
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-7542
Practice Address - Country:US
Practice Address - Phone:305-825-4422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL220030013OtherRAILROAD MEDICARE
FLCH5809OtherRAILROAD MEDICARE
FL=========OtherTAX ID NUMBER
FLCH5809OtherRAILROAD MEDICARE