MGM Labs LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MGM LABS LLC

Practice address

11350 SW Village Pkwy Ste 314
Port St Lucie, FL 34987-2352

Phone

(561) 674-6292

NPI assigned

Mar 14, 2019

Last updated

Mar 14, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark G McGinley

Title

Ceo

Phone

(561) 674-6292

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552521600000",
    "number": "1881153393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 SW VILLAGE PKWY STE 314",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872352",
            "telephone_number": "561-674-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 SW VILLAGE PKWY STE 314",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872352",
            "telephone_number": "561-674-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGM LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-03-14",
        "status": "A",
        "authorized_official_last_name": "MCGINLEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-674-6292",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Elizabeth Merson, P.T.
• Damaris Mesa
• Lauren Messina
• Edmond Louis Metellus
• Joanise Metelus
• Jessi Micalizzi
• Michael a Garvin DPM PA
• Michael a Garvin DPM PA
• Michael a Garvin, DPM, PA
• Michael a Garvin, DPM, PA

• Clinical Medical Laboratory in Port St Lucie, FL
• Providers in Port St Lucie, 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 Mar 14, 2019; 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.