Technician, Pathology, Medical Laboratory
CUSTOM CROWNS
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1538813910 · enumerated 2022-02-04 · record updated 2022-02-04. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: TYSHAWN MARTIN, CEO · (305) 788-7779
Addresses and phones
- Practice location 5400 S UNIVERSITY DR, DAVIE, FL, 33328-5312 (954) 947-0641 Google Maps Apple Maps OpenStreetMap
- Mailing address 5202 PLUNKETT ST, HOLLYWOOD, FL, 33021-8023 (305) 788-7779 Google Maps Apple Maps OpenStreetMap
Specialties
- Pediatrics, Developmental - Behavioral Pediatrics 2080P0006X
- Pathology, Clinical Laboratory Director, Non-physician 247ZC0005X
- Clinic/Center 261Q00000X
- Clinic/Center, Community Health 261QC1500X
- Clinic/Center, Health Services 261QH0100X
- Clinic/Center, Infusion Therapy 261QI0500X
- Clinic/Center, Mental Health (Including Community Mental Health Center) 261QM0801X
- Clinic/Center, Multi-Specialty 261QM1300X
- Clinic/Center, Occupational Medicine 261QX0100X
- Clinical Medical Laboratory 291U00000X
- Technician, Pathology, Medical Laboratory 246RM2200X · Primary
In this directory
FL Broward County Davie Technician, Pathology, Medical Laboratory
Locations and evidence
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Practice location
DAVIE, FL, 333285312
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.