Rising Tide Reference Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

RISING TIDE REFERENCE LABORATORY

Practice address

495 N Hwy 17 92 Unit 101
Longwood, FL 32750-4487

Phone

(407) 476-1646

Fax

(352) 282-3975

NPI assigned

Feb 16, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey D Hrush

Title

Ceo

Phone

(407) 476-3667

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1669170882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 N HWY 17 92 UNIT 101",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504487",
            "telephone_number": "407-476-1646",
            "fax_number": "352-282-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N HWY 17 92 UNIT 101",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504487",
            "telephone_number": "407-476-1646",
            "fax_number": "352-282-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISING TIDE REFERENCE LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-16",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "HRUSH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-476-3667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Septis Riconalla
• Karen Ann Rifkin, LMHC
• William Patrick Riley, MA
• Rise Transportation Services LLC
• Rise Up Mental Health & Wellness Services, LLC
• Ashley Marie Ritter, DC
• Lauren Nicole Rivera Pagan, MD
• Andrea P Rivera
• Roselyn A Rivera, CNA
• Susan Francine Robbins, MED

• Clinical Medical Laboratory in Longwood, FL
• Providers in Longwood, 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 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.