NPIMap

Organization Active NPI

Integrated Regional Laboratories Pathology Services, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Bradenton, FL
National Provider Identifier
1780411678
Registry record updated Sep 16, 2024
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
6215 14TH St W
Bradenton, FL 34207-4611
Phone
(941) 798-6176
NPI assigned
Sep 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Michael Jamaine Davis
Title
Chief Operating Officer
Phone
(561) 402-4256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

6215 14TH St W
Bradenton, FL 34207-4611

Mailing address

PO Box 741087
Atlanta, GA 30374-1087

National Provider Directory

National Provider Directory
Tax ID family
Int Reg Lab Pthlgy SRVC132 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1780411678",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 14TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342074611",
            "telephone_number": "941-798-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED REGIONAL LABORATORIES PATHOLOGY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMAINE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "561-402-4256"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.