NPI Code Detail JSON Logo

1619718087 NPI number — PATRIOT LABORATORY LLC

NPI Number: 1619718087
Health Care Provider/Practitioner: PATRIOT LABORATORY LLC

Information about “1619718087” NPI (PATRIOT LABORATORY LLC) exists in 1619718087 in HTML format HTML  |  1619718087 in plain Text format TXT  |  1619718087 in PDF (Portable Document Format) PDF  |  1619718087 in an XML format XML  formats.

NPI Number : 1619718087 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619718087",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PATRIOT LABORATORY LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3705 S HWY 27",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CLERMONT",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34711-7950",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "407-446-6556",
    "MailingAddressFaxNumber": "888-304-2622",
    "FirstLinePracticeLocationAddress": "2380 SUNSET POINT RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CLEARWATER",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33765-1430",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "727-466-1028",
    "PracticeLocationAddressFaxNumber": "727-232-9779",
    "EnumerationDate": "06/01/2024",
    "LastUpdateDate": "11/20/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "REGINA",
    "AuthorizedOfficialFirstName": "VICKI",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "COO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "407-446-6556",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "291U00000X",
        "TaxonomyName": "Clinical Medical Laboratory",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.