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General NPI Number Information
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NPI Number | 1912603648
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Entity Type | Organization
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Legal Business Name | KRL PHLEBOTOMIST AND MEDICAL CONCIERGE SERVICE
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Dates
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Enumeration Date | 02/03/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 1321 NW 14TH ST
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City | MIAMI
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State | FL
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Zip | 33125-1673
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Country | US
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Telephone | 885-539-9948
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Fax | 888-553-9994
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Provider Business Mailing Address
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Address Line | PO BOX 246175
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-0119
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Country | US
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Telephone | 885-539-9948
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Fax | 888-553-9994
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Authorized Official
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Title or Position | MBG
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Name | LATOYA VAANESSA NICHOLAS ALEXNADER
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Credential |
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Telephone | 885-539-9948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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