Organization Active NPI

Integrated Regional Laboratories Pathology Services, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Winter Haven, FL
National Provider Identifier
1699688820
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
INTEGRATED REGIONAL LABORATORIES PATHOLOGY SERVICES, LLC
Practice address
2885 Havendale Blvd NW
Winter Haven, FL 33881-1829
Phone
(954) 507-6780
NPI assigned
Sep 28, 2026
Last updated
Sep 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Authorized official

Name
Michael Jamaine Davis
Title
Coo
Phone
(561) 402-4256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU Primary

Addresses

Primary practice location

2885 Havendale Blvd NW
Winter Haven, FL 33881-1829

Mailing address

PO Box 741087
Atlanta, GA 30374-1087
Phone (954) 507-6780

NPI Registry JSON

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

{
    "created_epoch": "1790553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790553600000",
    "number": "1699688820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741087",
            "telephone_number": "954-507-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2885 HAVENDALE BLVD NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338811829",
            "telephone_number": "954-507-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED REGIONAL LABORATORIES PATHOLOGY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-28",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMAINE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "561-402-4256"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.