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General NPI Number Information
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NPI Number | 1881583920
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Entity Type | Organization
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Legal Business Name | MAYPORT MOLECULAR LLC
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 2550 MAYPORT RD STE 3
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City | JACKSONVILLE
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State | FL
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Zip | 32233-2872
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Country | US
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Telephone | 904-490-8316
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Fax |
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Provider Business Mailing Address
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Address Line | 2550 MAYPORT RD STE 3
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City | JACKSONVILLE
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State | FL
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Zip | 32233-2872
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Country | US
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Telephone | 904-490-8316
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SALIDER KUMAR
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Credential |
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Telephone | 470-945-4266
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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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