Organization
MOBIL LAB FOR ALL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSA I RIVERA ASCP (PROPRIETOR)
(561) 386-7182
Entity
Organization
Contact information
Practice address
1053 SW 12TH ST, BOCA RATON, FL 33486-5490
(561) 386-7182
Mailing address
1053 SW12TH ST, BOCA RATON, FL 33486
(561) 386-7182
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26988979
LICENSE
FL
Enumeration date
04/21/2020
Last updated
02/04/2021
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