MEDICARE: SOURCE OF LIFE MOBILE LABS

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	:	1922944990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOURCE OF LIFE MOBILE LABS

Provider Business Mailing Address
First Line	:	7132 KARDEN WAY
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-4631
Country	:	US
Telephone Number	:	407-779-0924
Fax Number	:

Provider Business Practice Location Address
First Line	:	7132 KARDEN WAY
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-4631
Country	:	US
Telephone Number	:	407-779-0924
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	WILLESHCA RAMOS
Credential	:	CPT
Telephone Number	:	407-779-0924

Provider Enumeration Date	:	04/23/2026
Last Update Date	:	04/23/2026

Similar Medicare Providers

1306782370 — WILLESHCA RAMOS CPT
Practice Location Address:

7132 KARDEN WAY
ORLANDO, FL
32822-4631

Practice Phone: 407-779-0924
Practice Fax:

1871526384 — BOSTWICK LABORATORIES INC
Practice Location Address:

6925 LAKE ELLENOR DR , SUITE 2
ORLANDO, FL
32809-4631

Practice Phone: 407-888-9937
Practice Fax: 407-856-0333

1619146909 — MRS. TAHSEEN AKRAM RAWLS R.D
Practice Location Address:

6925 LAKE ELLENOR DR , SUITE 650
ORLANDO, FL
32809-4631

Practice Phone: 407-852-1751
Practice Fax: 407-852-1748

1982936118 — DIANA CAROLINA ABRIL-MEDINA
Practice Location Address:

6925 LAKE ELLENOR DR STE 12020
ORLANDO, FL
32809-4631

Practice Phone: 407-301-1845
Practice Fax: 407-988-1600

1417659103 — FRANCKLINE LAMOUR
Practice Location Address:

2121 S HIAWASSEE RD APT 4631
ORLANDO, FL
32835-8770

Practice Phone: 407-664-7888
Practice Fax:

1366458978 — REGENETICS HEALTH INSTITUTE, PA
Practice Location Address:

7806 LAKE UNDERHILL RD STE 106
ORLANDO, FL
32822-8232

Practice Phone: 407-483-4079
Practice Fax: 407-572-8642

Directions to “SOURCE OF LIFE MOBILE LABS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.