NPIMap

Organization Active NPI

Medytox Medical Management Solutions Corp

  • Clinical Medical Laboratory
  • Jupiter, FL
National Provider Identifier
1700172186
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MEDYTOX MEDICAL MANAGEMENT SOLUTIONS CORP
Practice address
1080 E Indiantown Rd
Suite 100
Jupiter, FL 33477-5100
Phone
(561) 746-0623
Fax
(561) 746-6844
NPI assigned
Jun 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Authorized official

Name
Mr. William Forhan
Title
President
Phone
(561) 746-0623

Specialties & licenses 1

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

Addresses

Primary practice location

1080 E Indiantown Rd
Suite 100
Jupiter, FL 33477-5100

Mailing address

1080 E Indiantown Rd
Suite 100
Jupiter, FL 33477-5100
Phone (561) 746-0623

National Provider Directory

National Provider Directory

Locations

1080 E Indiantown Rd
Ste 100
Jupiter, FL 33477
Phone (561) 746-0623

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1700172186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 E INDIANTOWN RD",
            "address_2": "SUITE 100",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334775100",
            "telephone_number": "561-746-0623",
            "fax_number": "561-746-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 E INDIANTOWN RD",
            "address_2": "SUITE 100",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334775100",
            "telephone_number": "561-746-0623",
            "fax_number": "561-746-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDYTOX MEDICAL MANAGEMENT SOLUTIONS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "FORHAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-746-0623",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.