NPIMap

Organization Active NPI

Millenium Laboratories LLC

  • Clinical Medical Laboratory
  • Tampa, FL
National Provider Identifier
1619073442
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
800020748 Issued in FL
Legal business name
MILLENIUM LABORATORIES LLC
Practice address
3602 Spectrum Blvd
Tampa, FL 33612-9401
Phone
(813) 396-9975
Fax
(813) 396-9977
NPI assigned
Sep 16, 2006
Last updated
Jul 31, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Authorized official

Name
John F. Egan
Title
MGRM
Phone
(870) 926-3063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 800020748 FL Primary

Addresses

Primary practice location

3602 Spectrum Blvd
Tampa, FL 33612-9401

Mailing address

PO Box 281117
Atlanta, GA 30384-1117
Phone (813) 396-9975

Other identifiers 1

IdentifierTypeStateIssuer
L9296OtherFLBCBS PROVIDER NUMBER

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1619073442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 281117",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841117",
            "telephone_number": "813-396-9975",
            "fax_number": "813-396-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 SPECTRUM BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129401",
            "telephone_number": "813-396-9975",
            "fax_number": "813-396-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENIUM LABORATORIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "EGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "MGRM",
        "authorized_official_telephone_number": "870-926-3063"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800020748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "L9296",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.