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General NPI Number Information
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NPI Number | 1780406298
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Entity Type | Organization
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Legal Business Name | SANCTIFIED HANDS MOBILE PHLEBOTOMY LLC
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Dates
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Enumeration Date | 10/26/2024
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 3750 GUNN HWY STE 306-D117
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City | TAMPA
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State | FL
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Zip | 33618-8905
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Country | US
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Telephone | 800-476-3171
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Fax |
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Provider Business Mailing Address
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Address Line | 3750 GUNN HWY STE 306-D117
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City | TAMPA
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State | FL
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Zip | 33618-8905
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Country | US
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Telephone | 800-508-7517
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Fax | 813-682-2157
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | MS. MASSIEREN LATOYA DAVIS
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Credential |
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Telephone | 888-508-7517
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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 |
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