Provider Demographics
NPI:1093852519
Name:MTECH-HEALTH INC
Entity Type:Organization
Organization Name:MTECH-HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-892-1256
Mailing Address - Street 1:PO BOX 700201
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34770-0201
Mailing Address - Country:US
Mailing Address - Phone:407-892-1256
Mailing Address - Fax:407-892-1928
Practice Address - Street 1:1100 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-3582
Practice Address - Country:US
Practice Address - Phone:407-892-1256
Practice Address - Fax:407-892-1928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800019525291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2900Medicare ID - Type Unspecified