Physicians Stat Lab Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

L800011974 Issued in FL

Legal business name

PHYSICIANS STAT LAB INC.

Practice address

4290 S Hwy 27 Ste 204
Clermont, FL 34711-8066

Phone

(833) 782-8522

NPI assigned

Aug 13, 2006

Organization subpart

No

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

Authorized official

Name

Francisco Urteaga

Title

Owner

Phone

(305) 496-9038

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1467464917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 S HWY 27 STE 204",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118066",
            "telephone_number": "833-782-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 S HWY 27 STE 204",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118066",
            "telephone_number": "833-782-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS STAT LAB INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "URTEAGA",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-496-9038"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "L800011974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119047100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "L9069",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Physician Associates LLC
• Physician Associates LLC
• Physician Business Alliance Inc (Physician Business Alliance DBA Sports Medicine Institute)
• Physician Business Alliance Inc (Sports Medicine Institute)
• Physicians Medical Group, LLC (Physicians Medical Group)
• Pamela Pickett
• Teresa Pierre McDowall, NURSE PRACTITIONER
• Ashlee Pierre
• Lavonda Sherreece Pierre
• Mauviette Pierre, APRN

• 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 Sep 14, 2023; 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.