Organization
BORN DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH IRIS HERNANDEZ (CEO)
(772) 828-6992
Entity
Organization
Contact information
Practice address
6831 NW 20TH AVE, SUITE 107, FORT LAUDERDALE, FL 33309-1505
(772) 828-6992
Mailing address
340 SW QUIET WOODS, PORT SAINT LUCIE, FL 34953-8230
(772) 828-6992
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
FL
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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