Organization
PHYSICIANS STAT LAB EAST COAST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN HAWKINS (OWNER)
(407) 757-8747
Entity
Organization
Contact information
Practice address
1355 37TH ST STE 401, VERO BEACH, FL 32960-7322
(772) 569-6000
Mailing address
777 37TH ST, A107, VERO BEACH, FL 32960
(772) 569-6000
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
31702004
FL
Other
Enumeration date
01/20/2017
Last updated
10/29/2018
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