Healthcare Provider Details

I. General information

NPI: 1194659813
Provider Name (Legal Business Name): MEDCORE LABS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8571 NW SOUTH RIVER DR
MEDLEY FL
33166-7426
US

IV. Provider business mailing address

8571 NW SOUTH RIVER DR
MEDLEY FL
33166-7426
US

V. Phone/Fax

Practice location:
  • Phone: 786-332-9082
  • Fax: 800-701-6615
Mailing address:
  • Phone: 786-332-9082
  • Fax: 800-701-6615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SASHA EVANOSKI
Title or Position: OWNER
Credential:
Phone: 786-332-9082