Provider Demographics
NPI:1427522580
Name:JBS DIAGNOSTICS, LLC
Entity type:Organization
Organization Name:JBS DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:/SECRETARYTREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:SANON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-502-6289
Mailing Address - Street 1:9098 PARAGON WAY
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-5112
Mailing Address - Country:US
Mailing Address - Phone:561-502-6289
Mailing Address - Fax:561-491-5519
Practice Address - Street 1:3020 HIGH RIDGE RD STE 600
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8731
Practice Address - Country:US
Practice Address - Phone:561-502-6289
Practice Address - Fax:561-491-5519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory