Srconquest

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

C5Q7D6S2 Issued in FL

Legal business name

SRCONQUEST

Doing business as

Conquest Laboratories

Practice address

3255 NW 94TH Ave
#8736
Coral Springs, FL 33075-2001

Phone

(954) 805-4480

Fax

(954) 805-4480

NPI assigned

Jul 27, 2015

Last updated

Jul 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dwayne Coombs

Title

Ceo

Phone

(954) 805-4480

Specialties & licenses 1

Addresses

Other names 1

• Conquest Laboratories Doing business as

Locations

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437955200000",
    "number": "1508241936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3255 NW 94TH AVE",
            "address_2": "#8736",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330752001",
            "telephone_number": "954-805-4480",
            "fax_number": "954-805-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 NW 94TH AVE",
            "address_2": "#8736",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330752001",
            "telephone_number": "954-805-4480",
            "fax_number": "954-805-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRCONQUEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-07-27",
        "status": "A",
        "authorized_official_last_name": "COOMBS",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-805-4480",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "C5Q7D6S2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conquest Laboratories",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paulina A Splechta, DOULA
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• Springs Alternative Healing
• Springs Medical Supplies Inc
• Melissa B Spruce, CCC-SLP
• Gouri Sreepati, M.D
• Pierre Jerry St Gelus, PMHNP-BC
• Anderston St Germain, OT
• Francesca Alexis St Pierre, FNP
• Nestor Dominic St. Charles, L.M.H.C.

• Clinical Medical Laboratory in Coral Springs, FL
• Providers in Coral Springs, 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 Jul 27, 2015; 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.