PIONEER CLINICAL LAB LLC (NPI# 1417475872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417475872 |
| Entity Type | Organization |
| Organization Name | PIONEER CLINICAL LAB LLC |
| Practice Address |
9311 Sw Highway 200 # A2 Ocala FL 34481-9657 |
| Practice Telephone | 3525613179 |
| Practice Fax Number | 3526744386 |
| Mailing Telephone | 3523534212 |
| Mailing Fax Number | 3523885068 |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2020-04-08 |
| Authorized Official Name | EDWARD KOP (DELEGATED OFFICIAL) |
| Authorized Official Telephone | 3523620627 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246RM2200X |
Technician, Pathology Specialization: Medical Laboratory |
Technologists, Technicians & Other Technical Service Providers | ||
| Y | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
9311 SW HIGHWAY 200 # A2 |
| City | OCALA |
| State | FL |
| Zip Code | 34481-9657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982244190 | World Dental Associates Pa | Dentist | 8810 Sw State Rd 200, Suite 101, Ocala, FL 34481 | 2020-01-15 |
| 1609438019 | Quick Care Med LLC | Non-Pharmacy Dispensing Site | 8119 S State Road 200, Ocala, FL 34481 | 2019-07-05 |
| 1053875583 | Hugo Enrrique Chacin Jr. | Driver | 4098sw 114th Ct, Ocala, FL 34481 | 2019-01-29 |
| 1154803799 | Paige A Reid | Specialist/Technologist | 1160 Sw 140th Ave, Ocala, FL 34481 | 2018-08-30 |
| 1790262962 | Select Laboratories-marion County | Clinical Medical Laboratory | 11115 Sw 93rd Court Rd Unit 100, Ocala, FL 34481 | 2018-07-20 |
| 1114439270 | Audiology Services Company Usa, LLC | Clinic/Center | 8532 Southwest State Road 200, Ocala, FL 34481 | 2017-10-30 |
| 1518477686 | Tkv Dental | Dentist | 9401 Sw Sr 200, Suite 101, Ocala, FL 34481 | 2017-10-03 |
| 1467982363 | Susana Hernandez | Dentist | 8585 Sw State Rd 200, #3, Ocala, FL 34481 | 2017-06-14 |
| 1225577505 | Bridgewater Park LLC | Skilled Nursing Facility | 9280 Sw 81st Ct, Ocala, FL 34481 | 2017-02-20 |
| 1790223139 | Ocala Eye Optical, Inc. | Eyewear Supplier (Equipment, not the service) | 8520 Sw Sr 200, Ocala, FL 34481 | 2017-02-06 |
| Find all providers in zip 34481 | ||||
| Taxonomy Code | 247ZC0005X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Pathology |
| Specialization | Clinical Laboratory Director, Non-physician |
| An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |
| Notes: Source: National Uniform Claim Committee [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922626795 | Sabrina Yvette Kelley | Pathology | 801 W Sr 436 Ste 2005, Altamonte Springs, FL 32714-3053 | 2020-07-08 |
| 1407315575 | Aitor Lartitegui | Pathology | 15481 Sw 12th St Ste 303, Sunrise, FL 33326-1993 | 2019-03-18 |
| 1912479130 | Jean S Sanon | Pathology | 3020 High Ridge Rd Ste 600, Boynton Beach, FL 33426-8731 | 2018-12-28 |
| 1538645122 | Brandie Underwood | Pathology | 255 Se 7th Ave Ste 3, Crystal River, FL 34429-4848 | 2018-07-17 |
| 1083117535 | Quality Clinical Lab LLC | Pathology | 2204 Us Highway 19, Holiday, FL 34691-4351 | 2018-03-12 |
| 1407373368 | Cheska Lee Burleson | Pathology | 921 39th Ave Ne, Saint Petersburg, FL 33703-5924 | 2017-08-23 |
| 1356867048 | Kendall Ather Bryant | Pathology | 520 Baker St, Orlando, FL 32806 | 2017-08-15 |
| 1215329552 | Joseph Coscia | Pathology | 28 Bermuda Lake Dr, Palm Beach Gardens, FL 33418-4584 | 2015-02-24 |
| 1942600465 | Judith Mcmorris | Pathology | 4537 Winding River Way, Land O Lakes, FL 34639-5734 | 2014-09-03 |
| 1972756955 | Rafael Rodriguez | Pathology | 8004 Nw 154th St # 197, Miami Lakes, FL 33016-5814 | 2008-11-04 |
| Find all providers with the same taxonomy | ||||
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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.