Organization Active NPI

I MD Pathlab LLC

  • Dermatopathology (Pathology) Physician
  • West Palm Beach, FL
National Provider Identifier
1851554455
Registry record updated Feb 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
ME0069744 Issued in FL
Legal business name
I MD PATHLAB LLC
Practice address
1500 N Dixie Highway
Suite 308
West Palm Beach, FL 33401-2717
Phone
(561) 236-1711
Fax
(561) 736-9807
NPI assigned
Jul 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2009

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

Authorized official

Name
Dr. CR Jeanette Morales-Ducret, MD
Title
Owner
Phone
(561) 236-1711

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZD0900X ME0069744 FL Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

1500 N Dixie Highway
Suite 308
West Palm Beach, FL 33401-2717

Mailing address

1500 N Dixie Highway
Suite 308
West Palm Beach, FL 33401-2717
Phone (561) 236-1711

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1089676I/MD Pathlab LLC1500 N Dixie Hwy Ste 308, West Palm Beach, FL 33401ComplianceNov 5, 2026

National Provider Directory

National Provider Directory

Locations

1500 N Dixie Hwy
Ste 308
West Palm Beach, FL 33401
Phone (561) 236-1711

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233878400000",
    "number": "1851554455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N DIXIE HIGHWAY",
            "address_2": "SUITE 308",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012717",
            "telephone_number": "561-236-1711",
            "fax_number": "561-736-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N DIXIE HIGHWAY",
            "address_2": "SUITE 308",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012717",
            "telephone_number": "561-236-1711",
            "fax_number": "561-736-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I MD PATHLAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2009-02-06",
        "status": "A",
        "authorized_official_last_name": "MORALES-DUCRET",
        "authorized_official_first_name": "CR",
        "authorized_official_middle_name": "JEANETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-236-1711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Dermatopathology",
            "state": "FL",
            "license": "ME0069744",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West 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 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.