Healthcare Provider Details

I. General information

NPI: 1194475657
Provider Name (Legal Business Name): CAREFUL TOUCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 SW SAINT LUCIE WEST BLVD STE 106
PORT ST LUCIE FL
34986-1709
US

IV. Provider business mailing address

1420 SW SAINT LUCIE WEST BLVD STE 106
PORT ST LUCIE FL
34986-1709
US

V. Phone/Fax

Practice location:
  • Phone: 772-807-1910
  • Fax:
Mailing address:
  • Phone: 772-807-1910
  • Fax: 772-238-2293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TANGAYNIKA RICHARDSON
Title or Position: OWNER
Credential:
Phone: 772-807-1910