NPIMap

Organization Active NPI

Histopath Lab, PA- Toxicology

  • Clinical Medical Laboratory
  • Lecanto, FL
National Provider Identifier
1427467182
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
800001816 Issued in FL
Legal business name
HISTOPATH LAB, PA- TOXICOLOGY
Practice address
2671 W Norvell Bryant Hwy
Lecanto, FL 34461-9440
Phone
(352) 527-1344
Fax
(352) 527-2259
NPI assigned
Aug 7, 2014
Last updated
Aug 7, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
HISTOPATH LAB, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Authorized official

Name
Ms. Patricia Alexander
Title
Vice President
Phone
(352) 527-1344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 800001816 FL Primary

Addresses

Primary practice location

2671 W Norvell Bryant Hwy
Lecanto, FL 34461-9440

Mailing address

2671 W Norvell Bryant Hwy
Lecanto, FL 34461-9440
Phone (352) 527-1344

Other identifiers 1

IdentifierTypeStateIssuer
009504100MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Histopath Lab PA2 organizations share this tax ID, including this one
Part of
Histopath Lab PA

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407369600000",
    "number": "1427467182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2671 W NORVELL BRYANT HWY",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344619440",
            "telephone_number": "352-527-1344",
            "fax_number": "352-527-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2671 W NORVELL BRYANT HWY",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344619440",
            "telephone_number": "352-527-1344",
            "fax_number": "352-527-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HISTOPATH LAB, PA- TOXICOLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HISTOPATH LAB, P.A.",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-07",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "352-527-1344",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800001816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009504100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lecanto, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.