MEDICAL TOX LABS, LLC


Address: 3450 E Fletcher Ave, Suite 230, Tampa, FL 33613-4655
Phone: 8137698810

MEDICAL TOX LABS, LLC (NPI# 1285004283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285004283
Entity Type Organization
Organization Name MEDICAL TOX LABS, LLC
Other Organization Name WELLMED LABS
Practice Address 3450 E Fletcher Ave
Suite 230
Tampa
FL 33613-4655
Mailing Address 4730 N Habana Ave
Suite 204
Tampa
FL 33614-7163
Practice Telephone 8137698810
Practice Fax Number 8138701383
Mailing Telephone 8135492134
Mailing Fax Number 8138701383
Enumeration Date 2015-10-02
Last Update Date 2015-10-02
Authorized Official Name RODOLFO GARI (AUTHORIZED OFFICIAL)
Authorized Official Telephone 8135492134
Authorized Official Credential M.D.
Is Organization Subpart Y
Parent Organization Name MEDICAL TOX LABS, LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 291U00000X Clinical Medical Laboratory 800027605 FL Laboratories

Other Provider/Organization Names

Other Name Type Code
Wellmed Labs Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1285045153 Medical Tox Labs, LLC Clinical Medical Laboratory 3450 E Fletcher Ave, Suite 230, Tampa, FL 33613-4655 2014-05-14

Office Location

Street Address 3450 E FLETCHER AVE
SUITE 230
City TAMPA
State FL
Zip Code 33613-4655

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NPI Name Taxonomy Address Enumeration
1003896598 John C. Nobel Internal Medicine 3450 E Fletcher Ave, Suite 110, Tampa, FL 33613-4655 2006-01-19
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1285045153 Medical Tox Labs, LLC Clinical Medical Laboratory 3450 E Fletcher Ave, Suite 230, Tampa, FL 33613-4655 2014-05-14
1447548953 Amanda King Audiologist 3450 E Fletcher Ave, Suite 240, Tampa, FL 33613-4655 2011-07-18
1679886857 Holly A Hills Psychologist 3450 E Fletcher Ave, Suite 250, Tampa, FL 33613-4655 2010-07-16
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1720310162 Patti Lynn Barrows Psychologist 3450 E Fletcher Ave, Suite 250, Tampa, FL 33613-4655 2010-02-10
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1598289829 Lillian Perez Social Worker 13542 N Florida Avenue, Suite 210, Tampa, FL 33613 2017-07-28
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Taxonomy Information

Taxonomy Code 291U00000X
Grouping Laboratories
Classification Clinical Medical Laboratory

Taxonomy Definition

(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.

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City TAMPA
Zip Code 33613

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Dataset Information

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.

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