Organization
CAPITAL ADVANTAGE DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY A PUGLIESE (CEO)
(561) 201-8850
Entity
Organization
Contact information
Practice address
1860 OKEECHOBEE RD STE 510, WEST PALM BEACH, FL 33409-5242
(561) 619-6351
Mailing address
1860 OKEECHOBEE RD STE 510, WEST PALM BEACH, FL 33409-5242
(561) 619-6351
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D2130090
CLIA
FL
01
—
27580
COLA
FL
Enumeration date
07/07/2017
Last updated
07/21/2022
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