Organization
SPECTRUM DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALVIS VINCENT PUGLIESE (OWNER)
(877) 779-3711
Entity
Organization
Contact information
Practice address
823 SE OSCEOLA ST STE 5, STUART, FL 34994-2431
(877) 779-3711
(888) 726-8451
Mailing address
5283 W ATLANTIC AVE, DELRAY BEACH, FL 33484-8134
(877) 779-3711
(888) 726-8451
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D2164100
CLIA
FL
01
—
29449
COLA
FL
Enumeration date
04/10/2019
Last updated
04/12/2019
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