Vista Clinical Diagnostics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

800027066 Issued in FL

Legal business name

VISTA CLINICAL DIAGNOSTICS LLC

Practice address

4290 S Hwy 27
Suite 201
Clermont, FL 34711-8066

Phone

(352) 536-9270

Fax

(352) 536-9279

NPI assigned

Dec 13, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Davian S Santana

Title

President

Phone

(352) 536-9270

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Vista Clinical Diagnostics LLC

  • Clinical Medical Laboratory
  • Danville, VA
  • NPI 1780001859

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402617600000",
    "number": "1356326409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 S HWY 27",
            "address_2": "SUITE 201",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118066",
            "telephone_number": "352-536-9270",
            "fax_number": "352-536-9279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 S HWY 27",
            "address_2": "SUITE 201",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118066",
            "telephone_number": "352-536-9270",
            "fax_number": "352-536-9279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA CLINICAL DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2014-06-13",
        "status": "A",
        "authorized_official_last_name": "SANTANA",
        "authorized_official_first_name": "DAVIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-536-9270",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800027066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "800018794",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Villalta, DMD
• Alexis Viola
• Vip Anesthesia
• Visionary Vanguard Group
• Vista Adult Family Care Home LLC
• Vista Specialty Pharmacy
• Vista Specilty Pharmacy
• Huyen Lu Vitale, PT
• Kaely Delacruz Vivero, RBT
• VMD Primary Providers Central Florida PLLC

• Clinical Medical Laboratory in Clermont, FL
• Providers in Clermont, 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 Jun 13, 2014; 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.