Medicore Diagnostic Laboratory Corporation

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDICORE DIAGNOSTIC LABORATORY CORPORATION

Practice address

1895 Moon Cactus CT
Ruskin, FL 33570-5466

Phone

(307) 622-9550

NPI assigned

Apr 27, 2026

Organization subpart

No

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

Authorized official

Name

Amina Mumtaz Ahmad

Title

Ceo

Phone

(307) 622-9550

Specialties & licenses 1

Addresses

Tax ID family

Medicore Diagnostic Laboratory Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Medicore Diagnostic Laboratory Corporation

  • Urgent Care Clinic/Center
  • Ruskin, FL
  • NPI 1386574234
  NPD tax ID

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

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1487590899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 MOON CACTUS CT",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335705466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 MOON CACTUS CT",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335705466",
            "telephone_number": "307-622-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICORE DIAGNOSTIC LABORATORY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "AMINA MUMTAZ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "307-622-9550"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerice McCormack
• Lucinda McCrea
• Edward James McGlennon, PTA
• Medicina Totalcare LLC
• Medicore Diagnostic Laboratory Corporation
• Medisupport Services LLC
• Medisupport Services LLC
• Metampa, LLC
• Tiffany Miller
• Isabel Miranda Prieto

• Clinical Medical Laboratory in Ruskin, FL
• Providers in Ruskin, 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 Apr 27, 2026; 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.