Active NPI
Medarbor LLC
- Clinical Medical Laboratory
- Sunrise, FL
National Provider Identifier
1831855576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- MEDARBOR LLC
- Practice address
- 5600 NW 102ND Ave Ste GH
Sunrise, FL 33351-8709 - Phone
- (888) 590-0808
- Fax
- (267) 573-3646
- NPI assigned
- Nov 16, 2021
- Organization subpart
- Yes
- Parent organization
- MEDARBOR LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Matt Legowski
- Title
- Director of Operations
- Phone
- (888) 590-0808
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
5600 NW 102ND Ave Ste GH
Sunrise, FL 33351-8709
Mailing address
PO Box 301
Linwood, NJ 08221-0301
Phone (888) 590-0808
Other names 1
- Medarbor LLC Sunrise
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220414002460 | FL | Part B Supplier - Independent Clinical Laboratory | 6204100738 | Practice locations: Sunrise, FL |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Medarbor LLC
- Part of
- Medarbor LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Bristol, PA
- NPI 1407088156
-
- Clinical Medical Laboratory
- Bristol, PA
- NPI 1477076941
Locations
5600 NW 102nd Ave
Ste Gh
Sunrise, FL 33351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637020800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1637020800000",
"number": "1831855576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 301",
"city": "LINWOOD",
"state": "NJ",
"postal_code": "082210301",
"telephone_number": "888-590-0808",
"fax_number": "267-573-3646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5600 NW 102ND AVE STE GH",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333518709",
"telephone_number": "888-590-0808",
"fax_number": "267-573-3646"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDARBOR LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MEDARBOR LLC",
"enumeration_date": "2021-11-16",
"last_updated": "2021-11-16",
"certification_date": "2021-11-16",
"status": "A",
"authorized_official_last_name": "LEGOWSKI",
"authorized_official_first_name": "MATT",
"authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
"authorized_official_telephone_number": "888-590-0808"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Medarbor LLC Sunrise",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.