Organization
PATHEMA GX2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK AVERA (COO)
(754) 701-3746
Entity
Organization
Contact information
Practice address
5389 N NOB HILL RD, SUNRISE, FL 33351-4761
(754) 701-3746
Mailing address
5389 N NOB HILL RD, SUNRISE, FL 33351-4761
(754) 701-3746
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
09/14/2020
Last updated
10/08/2020
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