Physicians Stat Lab East Coast, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

31702004 Issued in FL

Legal business name

PHYSICIANS STAT LAB EAST COAST, LLC

Practice address

1355 37TH St Ste 401
Vero Beach, FL 32960-7322

Phone

(772) 569-6000

NPI assigned

Jan 20, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Nathan Hawkins

Title

Owner

Phone

(407) 757-8747

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1902343536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 37TH ST",
            "address_2": "A107",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "32960",
            "telephone_number": "772-569-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 37TH ST STE 401",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607322",
            "telephone_number": "772-569-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS STAT LAB EAST COAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-757-8747",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "31702004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Vero Beach, FL
• Providers in Vero Beach, 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 Oct 29, 2018; 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.