G. Cross Medical Labs, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

10D2097893 Issued in FL

Legal business name

G. CROSS MEDICAL LABS, LLC

Practice address

2901 N Dale Mabry Hwy
#612
Tampa, FL 33607-2412

Phone

(781) 864-1391

NPI assigned

Aug 12, 2016

Last updated

Aug 12, 2016By 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

Mr. Jacob Joseph Kallupura, ESQ.

Title

President/Ceo

Phone

(781) 864-1391

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470960000000",
    "number": "1750835278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17945 HUNTING BOW CIR",
            "address_2": "#101",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585376",
            "telephone_number": "781-864-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 N DALE MABRY HWY",
            "address_2": "#612",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336072412",
            "telephone_number": "781-864-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G. CROSS MEDICAL LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A",
        "authorized_official_last_name": "KALLUPURA",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "781-864-1391",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "10D2097893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Tampa, FL
• Providers in Tampa, 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 Aug 12, 2016; 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.