=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083586994
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PHLEBOMOBILE EXPRESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2025
-----------------------------------------------------
Last Update Date | 09/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1630 FOREST LAKES CIR APT C
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33406-5783
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-801-4306
-----------------------------------------------------
Fax | 561-880-6839
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1630 FOREST LAKES CIR APT C
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33406-5783
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-801-4306
-----------------------------------------------------
Fax | 561-880-6839
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | YAMELIS SALGADO FUENTES
-----------------------------------------------------
Credential | CPT
-----------------------------------------------------
Telephone | 346-812-7255
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 246Q00000X
-----------------------------------------------------
Taxonomy Name | Pathology Specialist/Technologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------