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General NPI Number Information
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NPI Number | 1255298618
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Entity Type | Organization
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Legal Business Name | PRIVATE LAB CARE ELITE, LLC
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 8237 NW SELVITZ RD UNIT 203
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-8270
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Country | US
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Telephone | 561-820-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 8237 NW SELVITZ RD UNIT 203
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-8270
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Country | US
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Telephone | 561-820-7800
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Fax |
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Authorized Official
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Title or Position | LAB DIRECTOR/FOUNDER
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Name | TINA GAITA
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Credential | CPT
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Telephone | 561-820-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Q00000X
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Taxonomy Name | Pathology Specialist/Technologist
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License Number |
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License Number State |
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