Provider Demographics
NPI:1720447527
Name:HEALTHY LIVING DIAGNOSTIC TESTING, LLC
Entity Type:Organization
Organization Name:HEALTHY LIVING DIAGNOSTIC TESTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-755-4357
Mailing Address - Street 1:731 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:TEQUESTA
Mailing Address - State:FL
Mailing Address - Zip Code:33469-2218
Mailing Address - Country:US
Mailing Address - Phone:561-755-4357
Mailing Address - Fax:561-203-2689
Practice Address - Street 1:731 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469-2218
Practice Address - Country:US
Practice Address - Phone:561-755-4357
Practice Address - Fax:561-203-2689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory