Organization
DESTINY BY THE SEA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA IACULLO (BILLING DIRECTOR)
(561) 715-9288
Entity
Organization
Contact information
Practice address
130 SE 14TH AVE, BOYNTON BEACH, FL 33435-6030
(561) 350-3888
Mailing address
130 SE 14TH AVE, BOYNTON BEACH, FL 33435-6030
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
06/17/2013
Last updated
06/17/2013
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