Healthcare Provider Details

I. General information

NPI: 1770416174
Provider Name (Legal Business Name): GENE-E MOBILE DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 BELLA VIDA BLVD APT 2203
ORLANDO FL
32828-6716
US

IV. Provider business mailing address

1106 CROSSTOWN WAY UNIT 2203
ORLANDO FL
32807-8329
US

V. Phone/Fax

Practice location:
  • Phone: 321-532-2082
  • Fax:
Mailing address:
  • Phone: 321-532-2082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHEENA EARLY
Title or Position: CEO
Credential:
Phone: 630-200-1403