Life Span Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LIFE SPAN INC

Practice address

265 SW Lake Forest Way
Port St Lucie, FL 34986-1771

Phone

(813) 477-0631

NPI assigned

Sep 29, 2015

Last updated

Sep 29, 2015By 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

Mercedes Boatwright

Title

Administrative

Phone

(352) 257-0575

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443484800000",
    "number": "1720458110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 SW LAKE FOREST WAY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861771",
            "telephone_number": "813-477-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 SW LAKE FOREST WAY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861771",
            "telephone_number": "813-477-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SPAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-29",
        "last_updated": "2015-09-29",
        "status": "A",
        "authorized_official_last_name": "BOATWRIGHT",
        "authorized_official_first_name": "MERCEDES",
        "authorized_official_title_or_position": "ADMINISTRATIVE",
        "authorized_official_telephone_number": "352-257-0575"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liberty Medical Supply Inc
• Life Care Centers of America, Inc. (Life Care Center of Port St. Lucie)
• Life Chiropractic Center PA
• Life Health Care Inc (Life Health Care 2)
• Life Long Learning Center, Inc
• Lifeline Mobile LLC
• Lighthouse Home Health Agency, LLC (Angels of Care)
• Lighthouse Support Services, Inc. (Lighthouse Group Home)
• Lorene Delia Ligouri, MD
• Sandslia Lima, ARNP

• Clinical Medical Laboratory in Port St Lucie, FL
• Providers in Port St Lucie, 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 Sep 29, 2015; 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.