NPIMap

Organization Active NPI

Way Beyond Detox

  • Clinical Medical Laboratory
  • Greenacres, FL
National Provider Identifier
1841689254
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
WAY BEYOND DETOX
Practice address
6415 Lake Worth Rd
102
Greenacres, FL 33463-2910
Phone
(561) 404-5872
NPI assigned
Jan 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Authorized official

Name
Angela Iacullo
Title
Billing Director
Phone
(561) 404-5872

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

6415 Lake Worth Rd
102
Greenacres, FL 33463-2910

Mailing address

6415 Lake Worth Rd
102
Greenacres, FL 33463-2910

National Provider Directory

National Provider Directory
Tax ID family
Way Beyond Detox2 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": "1421884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421884800000",
    "number": "1841689254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6415 LAKE WORTH RD",
            "address_2": "102",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334632910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6415 LAKE WORTH RD",
            "address_2": "102",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334632910",
            "telephone_number": "561-404-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAY BEYOND DETOX",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-22",
        "status": "A",
        "authorized_official_last_name": "IACULLO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "561-404-5872"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "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 Jan 22, 2015; 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.