LIBERTY HOUSE INC (NPI# 1124446703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124446703 |
| Entity Type | Organization |
| Organization Name | LIBERTY HOUSE INC |
| Practice Address |
504 Se 22nd St Fort Lauderdale FL 33316-3472 |
| Mailing Address |
1421 Nw 48th Dr Boca Raton FL 33431-3335 |
| Practice Telephone | 9545231167 |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2014-04-01 |
| Authorized Official Name | MR. ROBERT UNDERWOOD (MANAGER) |
| Authorized Official Telephone | 9545231167 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 10D207494 | FL | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | CLIA | 10D207494 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | LIBERTY HOUSE INC. | 248 Locust, Hammond, IN 46324 |
| Street Address |
504 SE 22ND ST |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33316-3472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064040 | Jonathan David Ortiz | Behavior Technician | 1717 Se 4 Ave, Fort Lauderdale, FL 33316 | 2020-05-15 |
| 1306311626 | Gateway Recovery Center, LLC | Counselor | 1421 Sw 4th Avenue, Suite B, Fort Lauderdale, FL 33316 | 2018-10-13 |
| 1588141626 | Natan Bastoky | Family Medicine | 1600 S Andrews Ave # Gme, Fort Lauderdale, FL 33316 | 2018-07-22 |
| 1104320126 | Kathleen Kanani Graham | Pharmacist | 1401 S. Federal Highway, Ft. Lauderdale, FL 33316 | 2018-03-23 |
| 1093224271 | Lacosta Therapy, LLC | Behavioral Analyst | 412 Se 15 St., #4, Ft. Lauderdale, FL 33316 | 2017-09-20 |
| 1124560370 | Yulia Rybalka | Pharmacist | 217 Se 10th Street, Ft Lauderdale, FL 33316 | 2016-11-04 |
| 1730635376 | Brian Alexander Reyes | Specialist/Technologist | 303 Se 3rd Ave, Ft Lauderdale, FL 33316 | 2016-09-01 |
| 1649726282 | Jennifer Tabares | Specialist/Technologist | 303 Southeast 3rd Av, Fort Lauderdale, FL 33316 | 2016-09-01 |
| 1609236850 | Diane Nicole Shilling | Nurse Practitioner | 1001 South Andrews Avenue, Suite 100, Ft. Lauderdale, FL 33316 | 2016-03-01 |
| 1396113239 | Victoria Rosado | Adult Companion | 150 Se 12th Street, 401(b), Fort Lauderdale, FL 33316 | 2015-09-09 |
| Find all providers in zip 33316 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346873338 | Diagnostic Labs of America LLC | Clinical Medical Laboratory | 3223 Nw 10th Ter Ste 606, Fort Lauderdale, FL 33309-5940 | 2020-02-18 |
| 1205315355 | Lab Gurus LLC | Clinical Medical Laboratory | 3316 Griffin Rd, Fort Lauderdale, FL 33312-5554 | 2018-08-09 |
| 1992294359 | Alicia Malone | Clinical Medical Laboratory | 2800 E Commercial Blvd Ste 212, Fort Lauderdale, FL 33308-4228 | 2018-05-01 |
| 1285160887 | Genlab Corporation | Clinical Medical Laboratory | 1417 Se 1st Ave, Fort Lauderdale, FL 33316-1805 | 2017-05-03 |
| 1982159703 | Andrekia Williams-montgomery | Clinical Medical Laboratory | 1471 Nw 22nd Ct Apt 1, Fort Lauderdale, FL 33311-3545 | 2016-08-22 |
| 1821440918 | Global Health Services Fl LLC | Clinical Medical Laboratory | 2030 W Mcnab Rd Ste 200, Fort Lauderdale, FL 33309-1002 | 2016-07-13 |
| 1811347891 | Soft Touch Mobile Lab Services | Clinical Medical Laboratory | 1471 Nw 22nd Ct, 1, Fort Lauderdale, FL 33311-3545 | 2016-06-21 |
| 1801291794 | Tpl Fl LLC | Clinical Medical Laboratory | 5817 N Andrews Way, Suite B, Fort Lauderdale, FL 33309-2359 | 2014-11-04 |
| 1346641875 | Em1 Labs, LLC | Clinical Medical Laboratory | 3115 Nw 10th Ter Ste 108, Fort Lauderdale, FL 33309-5937 | 2014-09-16 |
| 1790109742 | First Choice Laboratory LLC | Clinical Medical Laboratory | 6061 Ne 14th Ave, Fort Lauderdale, FL 33334-5007 | 2014-02-11 |
| Find all providers in FORT LAUDERDALE | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33316 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.