Organization
SUNCOAST DERMPATH LABORATORY & CONSULTATION, LLC
Active
Organization
SUNCOAST DERMPATH LABORATORY & CONSULTATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHURUN ZHAO M.D. (PRESIDENT)
(813) 598-2893
Entity
Organization
Contact information
Practice address
4431 WALTHAM DR, TAMPA, FL 33634-7345
(813) 598-2893
(888) 427-8643
Mailing address
4431 WALTHAM DR, TAMPA, FL 33634-7345
(813) 598-2893
(888) 427-8643
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
ME99158
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME99158
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280544800
—
FL
Enumeration date
02/16/2010
Last updated
09/02/2011
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