Organization
UNITED PATHOLOGIST LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK NAGRANI MD (PRESIDENT)
(386) 423-5500
Entity
Organization
Contact information
Practice address
610 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33603-3450
(386) 423-5500
Mailing address
612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800020973
FL
Other
Enumeration date
12/10/2012
Last updated
12/10/2012
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