Healthcare Provider Details

I. General information

NPI: 1871415356
Provider Name (Legal Business Name): FLORIDA HEALTH & DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 NORTH 6TH STREET
FORT PIERCE FL
34950
US

IV. Provider business mailing address

408 NORTH 6TH STREET
FORT PIERCE FL
34950
US

V. Phone/Fax

Practice location:
  • Phone: 772-807-3117
  • Fax: 772-807-3116
Mailing address:
  • Phone: 772-807-3117
  • Fax: 772-807-3116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MS. JASMINE NOEL
Title or Position: DIRECTOR
Credential:
Phone: 772-807-3117