Provider Demographics
NPI:1235327032
Name:DOLPHIN DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:DOLPHIN DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REGULATORY COMPLIANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOLLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-797-8461
Mailing Address - Street 1:10101 DR MARTIN LUTHER KING ST N STE 285
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-3823
Mailing Address - Country:US
Mailing Address - Phone:727-797-8461
Mailing Address - Fax:727-797-8467
Practice Address - Street 1:10101 DR MARTIN LUTHER KING ST N
Practice Address - Street 2:SUITE 285
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-3800
Practice Address - Country:US
Practice Address - Phone:727-797-8461
Practice Address - Fax:727-797-8467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE4709AOtherMEDICARE