Organization
BEIT HATIKVAH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY M WILLIAMAS (CEO)
(561) 899-4388
Entity
Organization
Contact information
Practice address
3910 RCA BLVD, SUITE 1015, PALM BEACH GARDENS, FL 33410-4284
(561) 899-4388
Mailing address
3910 RCA BLVD, SUITE 1015, PALM BEACH GARDENS, FL 33410-4284
(561) 899-4388
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
10D2016961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D2016961
CLIA - CERTIFICATE OF WAIVER
FL
Enumeration date
02/14/2011
Last updated
02/14/2011
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