Medarbor LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDARBOR LLC

Doing business as

Medarbor LLC Sunrise

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

Last updated

Nov 16, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

MEDARBOR LLCAs reported in NPPES

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

Addresses

Other names 1

• Medarbor LLC Sunrise Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Medarbor LLC

  dba MedArbor Diagnostics

  • Clinical Medical Laboratory
  • Bristol, PA
  • NPI 1477076941

  6204100738

  Same PAC ID

Tax ID family

Medarbor LLC3 organizations share this tax ID, including this one

Part of

Medarbor LLC

Other organizations with this tax ID 2

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

• Medarbor LLC

  • Community/Retail Pharmacy
  • Bristol, PA
  • NPI 1407088156
  NPD tax ID
• Medarbor LLC

  dba MedArbor Diagnostics

  • Clinical Medical Laboratory
  • Bristol, PA
  • NPI 1477076941
  NPD tax ID

Locations

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"
        }
    ]
}

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• Clinical Medical Laboratory in Sunrise, FL
• Providers in Sunrise, 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 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.

Verify at the official NPI Registry.