Organization
GENESTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DELUCA M.D. (CMO)
(561) 537-2603
Entity
Organization
Contact information
Practice address
4101 NW 4TH ST, SUITE 211, PLANTATION, FL 33317-2850
(561) 537-2603
Mailing address
1022 JEFFERY ST, BOCA RATON, FL 33487-4183
Taxonomy
Speciality
Code
Description
License number
State
261QG0250X
Genetics Clinic/Center
Primary
ME102199
ZZ
Other
Enumeration date
04/04/2013
Last updated
04/04/2013
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