| Organization Name: | LOGIC DIAGNOSTICS INC |
| NPI Number: | 1003229022 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NICOLAS GIACAMAN SALGADO (VICE PRESIDENT) |
| Mailing Address: | 18501 Pines Blvd Ste 205b Pembroke Pines |
| State: | FL US |
| Postal Code: | 330291414 |
| Phone Number: | 9542789088 |
| Fax Number: | 9546075825 |
| NPI Enumeration Date: | 06/06/2014 |
| NPI Last Update Date: | 06/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |