Active NPI
Shirley Louis
- Medical Laboratory Technician
- Winter Haven, FL
National Provider Identifier
1801679899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Laboratory Technician
- Practice address
- 65 3Rd St NW Ste 203
Winter Haven, FL 33881-4638 - Phone
- (863) 449-3963
- NPI assigned
- Aug 15, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | 23-1405 | FL | |
| Medical Laboratory Technician | 246RM2200X | FL | Primary |
Addresses
Primary practice location
65 3Rd St NW Ste 203
Winter Haven, FL 33881-4638
Mailing address
65 3Rd St NW Ste 203
Winter Haven, FL 33881-4638
Phone (863) 449-3963
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23-1405 | FL | MD | Phlebotomy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1801679899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 3RD ST NW STE 203",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338814638",
"telephone_number": "863-449-3963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 3RD ST NW STE 203",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338814638",
"telephone_number": "863-449-3963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOUIS",
"first_name": "SHIRLEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-15",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "FL",
"license": "23-1405",
"primary": false
},
{
"code": "246RM2200X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Medical Laboratory",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.