Healthcare Provider Details

I. General information

NPI: 1972336303
Provider Name (Legal Business Name): VAMPUTRIEVE LABS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9410 CERULEAN DR APT 303
RIVERVIEW FL
33578-4783
US

IV. Provider business mailing address

9410 CERULEAN DR APT 303
RIVERVIEW FL
33578-4783
US

V. Phone/Fax

Practice location:
  • Phone: 941-448-7121
  • Fax:
Mailing address:
  • Phone: 941-448-7121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS HARVEY
Title or Position: CERTIFIED PHLEBOTOMIST
Credential: CPT
Phone: 941-448-7121