Healthcare Provider Details

I. General information

NPI: 1811204993
Provider Name (Legal Business Name): Z-STAT MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 02/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34911 US HIGHWAY 19 N STE 525A
PALM HARBOR FL
34684-1966
US

IV. Provider business mailing address

34911 US HIGHWAY 19 N SUITE 525A
PALM HARBOR FL
34684-1966
US

V. Phone/Fax

Practice location:
  • Phone: 727-781-8124
  • Fax: 727-781-8190
Mailing address:
  • Phone: 727-781-8124
  • Fax: 727-781-8190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH24852
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LARRY SMITH
Title or Position: OWNER/MANAGER
Credential:
Phone: 727-547-2780