Organization Active NPI

Fission Diagnostics LLC

  • Clinical Medical Laboratory
  • North Palm Beach, FL
National Provider Identifier
1023476009
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
FISSION DIAGNOSTICS LLC
Practice address
613 Northlake Blvd Ste 4
North Palm Beach, FL 33408-5323
Phone
(561) 308-6452
NPI assigned
Feb 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mindy And
Title
Ceo
Phone
(561) 308-6452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X FL Primary

Addresses

Primary practice location

613 Northlake Blvd Ste 4
North Palm Beach, FL 33408-5323

Mailing address

416 Westwind Dr
North Palm Beach, FL 33408-5174

National Provider Directory

National Provider Directory

Locations

613 Northlake Blvd
Ste 4
North Palm Beach, FL 33408
Phone (561) 308-6452

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1023476009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 WESTWIND DR",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334085174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 NORTHLAKE BLVD STE 4",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334085323",
            "telephone_number": "561-308-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FISSION DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "AND",
        "authorized_official_first_name": "MINDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-308-6452"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.