MEDICARE: MEDCORE LABS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1194659813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDCORE LABS INC

Provider Business Mailing Address
First Line	:	8571 NW SOUTH RIVER DR
Second Line	:
City	:	MEDLEY
State	:	FL
Zip	:	33166-7426
Country	:	US
Telephone Number	:	786-332-9082
Fax Number	:	800-701-6615

Provider Business Practice Location Address
First Line	:	8571 NW SOUTH RIVER DR
Second Line	:
City	:	MEDLEY
State	:	FL
Zip	:	33166-7426
Country	:	US
Telephone Number	:	786-332-9082
Fax Number	:	800-701-6615

Authorized Official
Title or Position	:	OWNER
Name	:	SASHA EVANOSKI
Credential	:
Telephone Number	:	786-332-9082

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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