Organization Active NPI

Innovative GX Florida , Inc

  • Clinical Medical Laboratory
  • Boca Raton, FL
National Provider Identifier
1891721536
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
800009934 Issued in FL
Legal business name
INNOVATIVE GX FLORIDA , INC
Practice address
4805 NW 2ND Ave
Boca Raton, FL 33431-4141
Phone
(561) 235-3883
Fax
(866) 337-6895
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Authorized official

Name
Dr. Max O Solano, MD
Title
Medical Director
Phone
(561) 235-3883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 800009934 FL Primary

Addresses

Primary practice location

4805 NW 2ND Ave
Boca Raton, FL 33431-4141

Mailing address

4805 NW 2ND Ave
Boca Raton, FL 33431-4141
Phone (561) 235-3883

Other identifiers 1

IdentifierTypeStateIssuer
116503300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041027001007 FL Part B Supplier - Independent Clinical Laboratory 5395707897 Practice locations: Boca Raton, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0909364Innovative GX Florida Inc4805 NW 2ND Ave, Boca Raton, FL 33431AccreditationApr 10, 2027

National Provider Directory

National Provider Directory

Locations

500 University Blvd
Ste 102
Jupiter, FL 33458
Phone (561) 622-6610

1537 NW 65th Ave
Plantation, FL 33313
Phone (954) 271-1055

7808 W College Dr
Ste 10
Palos Heights, IL 60463
Phone (708) 671-1908

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738886400000",
    "number": "1891721536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 NW 2ND AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314141",
            "telephone_number": "561-235-3883",
            "fax_number": "866-337-6895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NW 2ND AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314141",
            "telephone_number": "561-235-3883",
            "fax_number": "866-337-6895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE GX FLORIDA , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A",
        "authorized_official_last_name": "SOLANO",
        "authorized_official_first_name": "MAX",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "561-235-3883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800009934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116503300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.