Healthcare Provider Details

I. General information

NPI: 1629758909
Provider Name (Legal Business Name): TOP NOTCH MOBLIE PHLEBOTOMTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 07/20/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5055 4TH AVE S
SAINT PETERSBURG FL
33707-1919
US

IV. Provider business mailing address

5055 4TH AVE S
SAINT PETERSBURG FL
33707-1919
US

V. Phone/Fax

Practice location:
  • Phone: 727-564-2302
  • Fax:
Mailing address:
  • Phone: 727-564-2302
  • 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: MISS JESSICA BOOKER
Title or Position: PHLEBOTOMIST
Credential:
Phone: 727-564-2302