Provider Demographics
NPI:1699369405
Name:PINK MOBILE LABS & DIAGNOSTICS
Entity type:Organization
Organization Name:PINK MOBILE LABS & DIAGNOSTICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-300-9290
Mailing Address - Street 1:2820 NE 214TH ST UNIT 8TH
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1268
Mailing Address - Country:US
Mailing Address - Phone:754-300-9290
Mailing Address - Fax:754-220-9053
Practice Address - Street 1:2820 NE 214TH ST UNIT 8TH
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1268
Practice Address - Country:US
Practice Address - Phone:754-300-9290
Practice Address - Fax:754-220-9053
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINK MOBILE LABS & DIAGNOSTICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-22
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0207XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile Mammography
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty
No251J00000XAgenciesNursing Care
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile