Provider Demographics
NPI:1033363270
Name:AVEE LABORATORIES INC
Entity Type:Organization
Organization Name:AVEE LABORATORIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-361-8989
Mailing Address - Street 1:14440 MYERLAKE CIR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-2813
Mailing Address - Country:US
Mailing Address - Phone:727-474-0600
Mailing Address - Fax:727-474-0610
Practice Address - Street 1:14440 MYERLAKE CIR
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-2813
Practice Address - Country:US
Practice Address - Phone:727-474-0600
Practice Address - Fax:727-474-0610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10D1063307291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001910800Medicaid
FL001910800Medicaid