Water Glass Laboratories Tampa Bay LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

WATER GLASS LABORATORIES TAMPA BAY LLC

Practice address

5880 49TH St N Ste 205
St Petersburg, FL 33709-2147

Phone

(727) 677-1018

NPI assigned

Oct 23, 2023

Organization subpart

No

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

Authorized official

Name

Jennifer Marie Rivard

Title

Owner

Phone

(727) 677-1018

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Rivard

  • Durable Medical Equipment & Medical Supplies
  • Clearwater, FL
  • NPI 1588288781
  NPD

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1073385233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 49TH ST N STE 205",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092147",
            "telephone_number": "727-677-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 49TH ST N STE 205",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092147",
            "telephone_number": "727-677-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATER GLASS LABORATORIES TAMPA BAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-23",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "RIVARD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-677-1018"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystal Washington
• Anna Wasilewska
• Joanne Donna Wasko, LCSW
• Harry Donald Wassel, M.D.
• Kathleen M Wasylik, MD
• Watercolor Dental LLC
• Amy Kennedy Waterman, M.A. CCC SLP
• Kathryn M Waterman, RPA-C, MPAS
• Waters Edge Medical Clinic Tampa LLC
• Michele Waters Suro

• Clinical Medical Laboratory in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.