Provider Demographics
NPI:1881780138
Name:VITRO MOLECULAR LABORATORIES
Entity type:Organization
Organization Name:VITRO MOLECULAR LABORATORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HADI
Authorized Official - Middle Name:
Authorized Official - Last Name:YAZIJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-267-7979
Mailing Address - Street 1:PO BOX 432160
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33243-2160
Mailing Address - Country:US
Mailing Address - Phone:305-267-7979
Mailing Address - Fax:786-513-0175
Practice Address - Street 1:8700 W FLAGLER ST STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2535
Practice Address - Country:US
Practice Address - Phone:305-267-7979
Practice Address - Fax:786-513-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10D1055514291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH13012Medicare UPIN