Organization
JACK A ROSS
Active
Other names
PATHOLOGY SERVICES INC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA M HILEMAN (OFFICE MANAGER)
(321) 505-2069
Entity
Organization
Contact information
Practice address
770 CIDCO RD, COCOA, FL 32926-5814
(321) 636-7766
(321) 636-0240
Mailing address
PO BOX 560977, ROCKLEDGE, FL 32956-0977
(321) 639-2404
(321) 635-7979
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800022292
FL
Other
Enumeration date
01/28/2008
Last updated
05/05/2008
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