NPIMap

Organization Active NPI

Pathology Medical Laboratories

  • Clinical Medical Laboratory
  • Leesburg, FL
National Provider Identifier
1003896853
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PATHOLOGY MEDICAL LABORATORIES
Practice address
913 B North Blvd E
Leesburg, FL 34748-5364
Phone
(352) 787-6733
Fax
(352) 787-9228
NPI assigned
Jan 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan Mary Rendon, MD
Title
President Pathology Medical Laberat
Phone
(352) 787-6733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

913 B North Blvd E
Leesburg, FL 34748-5364

Mailing address

913 B North Blvd E
Leesburg, FL 34748-5364
Phone (352) 787-6733

National Provider Directory

National Provider Directory

Locations

913 E North Blvd
Ste B
Leesburg, FL 34748
Phone (352) 360-1360

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1003896853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 B NORTH BLVD E",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485364",
            "telephone_number": "352-787-6733",
            "fax_number": "352-787-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 B NORTH BLVD E",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485364",
            "telephone_number": "352-787-6733",
            "fax_number": "352-787-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY MEDICAL LABORATORIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-18",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "RENDON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT PATHOLOGY MEDICAL LABERAT",
        "authorized_official_telephone_number": "352-787-6733",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.