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General NPI Number Information
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NPI Number | 1861992745
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Entity Type | Organization
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Legal Business Name | ELITE MOBILE LAB SERVICES, LLC
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 02/16/2018
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Provider Practice Location Address
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Address Line | 7711 SW ALBRITTON ST
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City | ARCADIA
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State | FL
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Zip | 34266-8717
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Country | US
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Telephone | 941-302-7745
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Fax |
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Provider Business Mailing Address
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Address Line | 7711 SW ALBRITTON ST
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City | ARCADIA
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State | FL
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Zip | 34266-8717
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHLEBOTOMIST/OWNER
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Name | MRS. KANDIS DRYMON
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Credential | CPT
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Telephone | 941-302-7745
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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 | 2511-8828
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License Number State | FL
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