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General NPI Number Information
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NPI Number | 1407113020
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Entity Type | Organization
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Legal Business Name | LABORATORY OF FLORIDA LLC
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 7520 W WATERS AVE STE 4
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City | TAMPA
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State | FL
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Zip | 33615-1599
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Country | US
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Telephone | 813-885-7755
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Fax | 813-885-6688
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Provider Business Mailing Address
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Address Line | 7520 W WATERS AVE STE 4
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City | TAMPA
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State | FL
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Zip | 33615-1599
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Country | US
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Telephone | 813-885-7755
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Fax | 813-885-6688
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Authorized Official
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Title or Position | CEO
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Name | MR. ANDREI LEONOV
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Credential |
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Telephone | 813-885-7755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | FL
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