NPIMap

Organization Active NPI

South Florida Recovery Center

  • Clinical Medical Laboratory
  • Greenacres, FL
National Provider Identifier
1801238563
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
10D2060593 Issued in FL
Legal business name
SOUTH FLORIDA RECOVERY CENTER
Practice address
4010 S 57TH Ave Ste 103
Greenacres, FL 33463-4301
Phone
(561) 275-2001
NPI assigned
Jul 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Authorized official

Name
Angela Iacullo
Title
Director
Phone
(561) 270-2361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 10D2060593 FL Primary

Addresses

Primary practice location

4010 S 57TH Ave Ste 103
Greenacres, FL 33463-4301

Mailing address

4010 S 57TH Ave Ste 103
Greenacres, FL 33463-4301

National Provider Directory

National Provider Directory
Tax ID family
South Florida Recovery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1801238563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 S 57TH AVE STE 103",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334634301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 S 57TH AVE STE 103",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334634301",
            "telephone_number": "561-275-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "IACULLO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "561-270-2361"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "10D2060593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; 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.