Organization
NEW FOUND LIFE OF DELRAY BEACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA IACULLO (BIRECTOR OF BILLING)
(561) 270-2361
Entity
Organization
Contact information
Practice address
223 NE 5TH AVE, SUITE 103-104, DELRAY BEACH, FL 33483-5530
(561) 270-2361
(561) 270-2081
Mailing address
210 NE 6TH AVE, 103-104, DELRAY BEACH, FL 33483-5540
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800027026
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D2035690
CLIA
FL
01
—
800027026
AGENCY FOR HEALTH CARE ADMINISTRATION
FL
Enumeration date
01/24/2014
Last updated
01/24/2014
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