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General NPI Number Information
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NPI Number | 1710896279
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Entity Type | Organization
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Legal Business Name | CRYSTAL CLEAR MOBILE PHLEBOTOMY,LLC
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Dates
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Enumeration Date | 09/02/2026
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Last Update Date | 09/02/2026
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Provider Practice Location Address
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Address Line | 1900 NORTH CONGRESS AVE BUILDING H #310
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City | WEST PALM BEACH
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State | FL
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Zip | 33401
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Country | US
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Telephone | 561-727-6118
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Fax |
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Provider Business Mailing Address
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Address Line | 1691 FORUM PL STE B
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-2336
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Country | US
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Telephone | 561-727-6118
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CRYSTAL UPSHAW
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Credential | RPT
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Telephone | 561-727-6118
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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 |
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License Number State |
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