MEDICARE: APEX TOXICOLOGY

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	:	1619397783
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APEX TOXICOLOGY

Provider Business Mailing Address
First Line	:	145 NW CENTRAL PARK PLZ
Second Line	:	SUITE 114
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-2482
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 NW CENTRAL PARK PLZ
Second Line	:	SUITE 114
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-2482
Country	:	US
Telephone Number	:	772-333-2199
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JON MCKENZIE
Credential	:
Telephone Number	:	772-333-2199

Provider Enumeration Date	:	04/16/2014
Last Update Date	:	04/16/2014

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Directions to “APEX TOXICOLOGY ” Practice Location

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