Organization
DEEP BLUE LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAYYAZ QAZI (CEO)
(407) 968-6305
Entity
Organization
Contact information
Practice address
1701 PARK CENTER DR, ORLANDO, FL 32835-6235
(407) 968-6305
Mailing address
1701 PARK CENTER DR, ORLANDO, FL 32835-6235
(407) 968-6305
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
07/16/2025
Last updated
07/16/2025
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