Provider Demographics
NPI:1447443528
Name:NORTH FLORIDA REPRODUCTIVE BIOLOGY LABORATORY
Entity type:Organization
Organization Name:NORTH FLORIDA REPRODUCTIVE BIOLOGY LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-399-5221
Mailing Address - Street 1:7051 SOUTHPOINT PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-8709
Mailing Address - Country:US
Mailing Address - Phone:904-493-2229
Mailing Address - Fax:904-396-4546
Practice Address - Street 1:7051 SOUTHPOINT PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8709
Practice Address - Country:US
Practice Address - Phone:904-493-2229
Practice Address - Fax:904-396-4546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory