Healthcare Provider Details

I. General information

NPI: 1457255747
Provider Name (Legal Business Name): GENERATIONS MOBILE PHLEBOTOMY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12316 CORONADO DR
SPRING HILL FL
34609-4709
US

IV. Provider business mailing address

12316 CORONADO DR
SPRING HILL FL
34609-4709
US

V. Phone/Fax

Practice location:
  • Phone: 813-498-9456
  • Fax: 877-567-0178
Mailing address:
  • Phone: 813-498-9456
  • Fax: 877-567-0178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: YENNYS DIAZ REYES
Title or Position: CO-OWNER / MANAGER
Credential:
Phone: 813-498-9456