Florida Laboratory Analysis, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

FLORIDA LABORATORY ANALYSIS, LLC

Practice address

6900 Southpoint Dr N Ste 220
Jacksonville, FL 32216-8075

Phone

(407) 960-3487

Fax

(407) 678-7246

NPI assigned

Oct 14, 2015

Last updated

Feb 12, 2021By 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

Sherri Ann Gwynn

Title

Billing Manager

Phone

(407) 960-3487

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Farrukh Ambareen, M.D.

  • Internal Medicine Physician
  • Gainesville, FL
  • NPI 1063404457
  NPD (past)
• Farha Mohamed Haji Jamaldin

  • Occupational Therapist
  • Ponte Vedra Beach, FL
  • NPI 1649668096
  NPD (past)

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613088000000",
    "number": "1710358932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 521121",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327521121",
            "telephone_number": "407-679-3337",
            "fax_number": "407-678-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 SOUTHPOINT DR N STE 220",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168075",
            "telephone_number": "407-960-3487",
            "fax_number": "407-678-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA LABORATORY ANALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A",
        "authorized_official_last_name": "GWYNN",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "407-960-3487"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Jacksonville, FL
• Providers in Jacksonville, 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 Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.