Rico Lab Services

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

RICO LAB SERVICES

Practice address

601 S Harbour Island Blvd Ste 109
Tampa, FL 33602-5927

Phone

(813) 419-2934

NPI assigned

May 26, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Federico Gordon Jr., MBA, MLS(ASCP)

Title

Ceo

Phone

(813) 419-2934

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592092800000",
    "number": "1447873344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 109",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025927",
            "telephone_number": "813-419-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 109",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025927",
            "telephone_number": "813-419-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICO LAB SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-06-14",
        "certification_date": "2020-06-14",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "FEDERICO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-419-2934",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MBA, MLS(ASCP)"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://humblefax.com/",
            "affiliation": "N",
            "endpointDescription": "Electronic Fax",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "e-mail, Fax",
            "address_1": "601 S Harbour Island Blvd Ste 109",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336025927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dory Lynn Ricker, BA
• Cody Ellis Rickett
• Bridget Rickman, AU.D.
• Clayton L. Ricks, DMD
• Ricky P. Lockett, D.O, PA
• Juan Felipe Rico, MD
• Nicole Carnevalla Riddell, M.D.
• Scott R. Riddell, MD
• Emma Rouse Riddle, PA-C
• Teresa M Riddle

• Clinical Medical Laboratory in Tampa, FL
• Providers in Tampa, 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 14, 2020; 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.