Medstar Laboratory of Florida, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDSTAR LABORATORY OF FLORIDA, INC

Practice address

10277 Windhorst Rd
Tampa, FL 33619-7820

Phone

(844) 291-4292

Fax

(813) 628-9319

NPI assigned

Sep 25, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Kirill Vesselov

Title

Ceo

Phone

(844) 291-4292

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553040000000",
    "number": "1235480641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10277 WINDHORST RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336197820",
            "telephone_number": "844-291-4292",
            "fax_number": "813-628-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10277 WINDHORST RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336197820",
            "telephone_number": "844-291-4292",
            "fax_number": "813-628-9319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR LABORATORY OF FLORIDA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-25",
        "last_updated": "2019-03-20",
        "status": "A",
        "authorized_official_last_name": "VESSELOV",
        "authorized_official_first_name": "KIRILL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "844-291-4292",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.