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General NPI Number Information
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NPI Number | 1104615103
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Entity Type | Organization
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Legal Business Name | LEVEL 6 LABS LLC
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 4343 QUEEN ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33714-4244
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Country | US
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Telephone | 727-210-5576
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Fax |
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Provider Business Mailing Address
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Address Line | 204 37TH AVE N UNIT 466
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City | SAINT PETERSBURG
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State | FL
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Zip | 33704-1416
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ALEXANDER MINELLA
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Credential |
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Telephone | 727-210-5576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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