MEDICARE: MR. UMANGBHAI A RAVAL

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		KY

General Provider Information

NPI Number	:	1477420651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. UMANGBHAI A RAVAL

Provider Business Mailing Address
First Line	:	2001 GARDEN SPRINGS DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3464
Country	:	US
Telephone Number	:	859-310-0787
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 GARDEN SPRINGS DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3464
Country	:	US
Telephone Number	:	859-310-0787
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	10/21/2025

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