Stlab Florida LLC

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

Legal business name

STLAB FLORIDA LLC

Practice address

12177 SW 132ND CT
Miami, FL 33186-6410

Phone

(786) 237-5664

NPI assigned

Nov 9, 2022

Last updated

Nov 9, 2022By 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

Luis Rodolfo Castro Concha

Title

Office Manager

Phone

(786) 237-5664

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1942918891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12177 SW 132ND CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331866410",
            "telephone_number": "786-237-5664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12177 SW 132ND CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331866410",
            "telephone_number": "786-237-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STLAB FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "CASTRO CONCHA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "RODOLFO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "786-237-5664"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LAB",
            "identifier": "DL12105",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA REVENUE CERTIFICATE NUMBER",
            "identifier": "2380187665136",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.