MEDICARE: PLEASANT STICK MOBILE LAB LLC

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	246RP1900X	Phlebotomy Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10D2299617	OTHER	FL	CLIA

General Provider Information

NPI Number	:	1518800374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLEASANT STICK MOBILE LAB LLC

Provider Business Mailing Address
First Line	:	3111 SW 17TH AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-4976
Country	:	US
Telephone Number	:	941-500-9359
Fax Number	:	239-349-9655

Provider Business Practice Location Address
First Line	:	3111 SW 17TH AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-4976
Country	:	US
Telephone Number	:	941-500-9359
Fax Number	:	239-349-9655

Authorized Official
Title or Position	:	OWNER/MANAGING MEMBER
Name	:	MS. APRIL DAVIS
Credential	:	CPT, RMA
Telephone Number	:	941-500-9359

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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Directions to “PLEASANT STICK MOBILE LAB LLC ” Practice Location

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