Healthcare Provider Details

I. General information

NPI: 1104252287
Provider Name (Legal Business Name): ACCESS LABORATORIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 12/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11373 CORTEZ BLVD STE 302
BROOKSVILLE FL
34613-5411
US

IV. Provider business mailing address

14690 SPRING HILL DRIVE SUITE 101
SPRING HILL FL
34609
US

V. Phone/Fax

Practice location:
  • Phone: 352-596-7705
  • Fax: 352-597-8901
Mailing address:
  • Phone: 352-799-0046
  • Fax: 352-799-0042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number800006385
License Number StateFL

VIII. Authorized Official

Name: DR. PARIKSITH SINGH
Title or Position: CEO
Credential: MD
Phone: 352-799-0046