Organization
IDEAL DIAGNOSTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KWAME AGYEMAN (MANAGER)
(786) 589-7215
Entity
Organization
Contact information
Practice address
2065 NE 163RD ST, NORTH MIAMI BEACH, FL 33162-4901
(786) 589-7215
(786) 743-2243
Mailing address
2065 NE 163RD ST, NORTH MIAMI BEACH, FL 33162-4901
(786) 589-7215
(786) 743-2243
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/27/2022
Last updated
10/27/2022
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