Organization
HISTODERM GROUP LLC
Active
Organization
HISTODERM GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISVETT MARTINEZ (OWNER)
(305) 934-5046
Entity
Organization
Contact information
Practice address
7091 SW 47TH ST STE C, MIAMI, FL 33155-4652
(305) 934-5046
Mailing address
7091 SW 47TH ST STE C, MIAMI, FL 33155-4652
(305) 934-5046
Taxonomy
Speciality
Code
Description
License number
State
246QL0900X
Laboratory Management Specialist/Technologist
Primary
—
—
Other
Enumeration date
10/28/2025
Last updated
10/28/2025
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