Healthcare Provider Details

I. General information

NPI: 1588390785
Provider Name (Legal Business Name): SIMPLY DRAW PHLEBOTOMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 NE 173RD ST
NORTH MIAMI BEACH FL
33162-1540
US

IV. Provider business mailing address

1800 NE 173RD ST
NORTH MIAMI BEACH FL
33162-1540
US

V. Phone/Fax

Practice location:
  • Phone: 305-741-1310
  • Fax: 954-827-0446
Mailing address:
  • Phone: 305-741-1310
  • Fax: 954-827-0446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MAKEDA BLAKE
Title or Position: OWNER
Credential:
Phone: 305-741-1310