Hga Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

8000015297 Issued in FL

Legal business name

HGA LAB LLC

Practice address

12190 Cortez Blvd
Brooksville, FL 34613-5578

Phone

(352) 597-1206

Fax

(352) 597-9715

NPI assigned

Apr 3, 2012

Organization subpart

No

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

Authorized official

Name

Ramakrishna P Kanuri, M.D.

Title

MGRM

Phone

(352) 597-1206

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1376809426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12190 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135578",
            "telephone_number": "352-597-1206",
            "fax_number": "352-597-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12190 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135578",
            "telephone_number": "352-597-1206",
            "fax_number": "352-597-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HGA LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "KANURI",
        "authorized_official_first_name": "RAMAKRISHNA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MGRM",
        "authorized_official_telephone_number": "352-597-1206",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "8000015297",
            "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 Apr 3, 2012; 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.