Provider Demographics
NPI:1811340474
Name:MEDLABS OF FLORIDA, LLC
Entity type:Organization
Organization Name:MEDLABS OF FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP & COO
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:MITILENES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-731-2900
Mailing Address - Street 1:85 HORSEHILL RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927-2003
Mailing Address - Country:US
Mailing Address - Phone:973-731-2900
Mailing Address - Fax:973-500-6332
Practice Address - Street 1:601 N CONGRESS AVE
Practice Address - Street 2:UNIT 608
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4703
Practice Address - Country:US
Practice Address - Phone:973-731-2900
Practice Address - Fax:973-500-6332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory