Florida Medical Lab

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

FLORIDA MEDICAL LAB

Practice address

631 W 23Rd St
Panama City, FL 32405-3922

Phone

(980) 721-6622

NPI assigned

Oct 6, 2023

Organization subpart

Yes

Parent organization

CAROLINA MEDICAL LAB GROUP INCAs reported in NPPES

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

Authorized official

Name

Omar Idlibi, MDNPI 1962407189

Title

Owner

Phone

(980) 721-6622

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Tax ID family

Carolina Medical Lab Group Inc2 organizations share this tax ID, including this one

Part of

Carolina Medical Lab Group Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Carolina Medical Lab Group Inc.

  • Clinical Medical Laboratory
  • Charlotte, NC
  • NPI 1992700124
  NPD tax ID

Locations

Practitioners 1

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

• Omar Idlibi, MD

  • Anatomic Pathology Physician
  • Charlotte, NC
  • NPI 1962407189
  NPD Authorized official

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

{
    "created_epoch": "1696550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1144001074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053922",
            "telephone_number": "980-721-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA MEDICAL LAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINA MEDICAL LAB GROUP INC",
        "enumeration_date": "2023-10-06",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "IDLIBI",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "980-721-6622",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Florida Internal Medicine Group
• Florida Mentor II LLC
• Florida Panhandle Anesthesia Associates, LLC
• Florida Panhandle Pediatric Foundation, Inc.
• Florida Regional Intensivist Services, LLC
• Florida Sports Medicine & Orthopaedics PA

• All providers in Panama City, FL
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.