Kristen Idowu

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

Practice address

12236 Tavares Ridge LN
Tavares, FL 32778-4460

Phone

(352) 636-2821

NPI assigned

Mar 13, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tru3 Laboratory LLC

  • Clinical Medical Laboratory
  • Tavares, FL
  • NPI 1225897804
  NPD Authorized official

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1043079072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12236 TAVARES RIDGE LN",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784460",
            "telephone_number": "352-636-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12236 TAVARES RIDGE LN",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784460",
            "telephone_number": "352-636-2821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDOWU",
        "first_name": "KRISTEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10D2292576",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "922686490",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Homepoint Visiting Physicians Group, Inc.
• Hospital Care Associates PA
• Vestali A Hudak
• Randolph Gray Hunter, MD
• Michael Clifford Hurwitz
• Infectious Disease of Lake County,LLC
• Innovative Homcare, LLC.
• Innovative Homecare, LLC.
• Interactive ABA Services
• Erica Denise Irvin

• Phlebotomy Technician in Tavares, FL
• Providers in Tavares, FL by specialty
• Phlebotomy Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.