Organization
FIRST COAST PATHOLOGY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRENDRA DESAI MD (PHYSICIAN)
(904) 302-3553
Entity
Organization
Contact information
Practice address
9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257
(904) 302-3553
Mailing address
9102 DUCALE WAY APT 204, PALM BEACH GARDENS, FL 33418-8164
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
ME 93419
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2764806 00
—
FL
Enumeration date
09/18/2015
Last updated
09/18/2015
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