Maverick Labs LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

800028324 Issued in FL

Legal business name

MAVERICK LABS LLC

Practice address

4601 N Congress Ave Suite 203
West Palm Beach, FL 33407

Phone

(561) 806-0990

Fax

(561) 423-2495

NPI assigned

Nov 14, 2016

Organization subpart

No

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

Authorized official

Name

Joshua Hirth

Title

Owner

Phone

(561) 504-8343

Specialties & licenses 1

Addresses

Other names 1

• Optum Labs LLC Former legal business name

Locations

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1811439433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 N CONGRESS AVE SUITE 203",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33407",
            "telephone_number": "561-806-0990",
            "fax_number": "561-423-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 N CONGRESS AVE SUITE 203",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33407",
            "telephone_number": "561-806-0990",
            "fax_number": "561-423-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-14",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "HIRTH",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-504-8343"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800028324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optum Labs LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kili Mauga
• Marlene Maure Brito
• Philip Arthur Mauri, D.C.
• Mauricio E. Melhado, M.D., P.a.
• Andrea Mauro, DC
• Maximum Achievers, LLC
• Frances D. Maxwell-Baxter
• Laura Suzanne Maxwell, BA
• Avery May, MH 19441
• Eric Michael May, PA-C

• Clinical Medical Laboratory in West Palm Beach, FL
• Providers in West Palm Beach, 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 Nov 25, 2020; 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.