Organization
COAST TO COAST DIAGNOSTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIBEL QUEVEDO (PRESIDENT)
(305) 642-0017
Entity
Organization
Contact information
Practice address
138 BEACOM BLVD, MIAMI, FL 33135-1534
(305) 642-0017
(305) 642-2731
Mailing address
138 BEACOM BLVD, MIAMI, FL 33135-1534
(305) 642-0017
(305) 642-2731
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
HCC5623
FL
Other
Enumeration date
05/17/2006
Last updated
06/23/2008
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