Basic Information
| Provider Information | |||||||||
| NPI: | 1154601912 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EAST COAST PATHOLOGY OF FLORIDA, PA | ||||||||
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| Address1: | 595 N NOVA RD | ||||||||
| Address2: | SUITE 118 | ||||||||
| City: | ORMOND BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321744424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3862313523 | ||||||||
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| Practice Location | |||||||||
| Address1: | 595 N NOVA RD | ||||||||
| Address2: | SUITE 118 | ||||||||
| City: | ORMOND BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321744424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3862313523 | ||||||||
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| ProviderEnumerationDate: | 08/25/2011 | ||||||||
| LastUpdateDate: | 08/25/2011 | ||||||||
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| AuthorizedOfficialLastName: | AROCHO | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3862313523 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.