MEDICARE: ASSURED HEALING DIAGNOSTICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1437029634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSURED HEALING DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	6370 SW THISTLE TER
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-3955
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6370 SW THISTLE TER
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-3955
Country	:	US
Telephone Number	:	805-881-5124
Fax Number	:

Authorized Official
Title or Position	:	ADMIN
Name	:	TANYA HILER
Credential	:
Telephone Number	:	805-881-5124

Provider Enumeration Date	:	11/11/2025
Last Update Date	:	11/11/2025

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