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General NPI Number Information
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NPI Number | 1568277788
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Entity Type | Individual
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Provider Name | ADREIKA V FLUELLEN
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Gender | Female
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 333 3RD AVE N # 200B
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-3899
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Country | US
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Telephone | 866-735-8065
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Fax | 727-202-7331
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Provider Business Mailing Address
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Address Line | 333 3RD AVE N # 200B
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-3899
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Country | US
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Telephone | 866-735-8065
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Fax | 727-202-7331
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | 25R-CPT251
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number | 10D2314950
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License Number State | FL
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