Coast to Coast Diagnostic Inc

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

License

HCC5623 Issued in FL

Legal business name

COAST TO COAST DIAGNOSTIC INC

Practice address

138 Beacom Blvd
Miami, FL 33135-1534

Phone

(305) 642-0017

Fax

(305) 642-2731

NPI assigned

May 17, 2006

Last updated

Jun 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maribel Quevedo

Title

President

Phone

(305) 642-0017

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1982656070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 BEACOM BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331351534",
            "telephone_number": "305-642-0017",
            "fax_number": "305-642-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 BEACOM BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331351534",
            "telephone_number": "305-642-0017",
            "fax_number": "305-642-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST TO COAST DIAGNOSTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "QUEVEDO",
        "authorized_official_first_name": "MARIBEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-642-0017"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "FL",
            "license": "HCC5623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Miami, FL
• Providers in Miami, FL by specialty
• Physiological Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.