Provider Demographics
NPI:1326221151
Name:MOBILELAB,CO
Entity Type:Organization
Organization Name:MOBILELAB,CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-298-2499
Mailing Address - Street 1:2301 E SLIGH AVE
Mailing Address - Street 2:SUITE 39
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-1336
Mailing Address - Country:US
Mailing Address - Phone:813-298-2499
Mailing Address - Fax:813-985-0247
Practice Address - Street 1:2301 E SLIGH AVE
Practice Address - Street 2:SUITE 39
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-1336
Practice Address - Country:US
Practice Address - Phone:813-298-2499
Practice Address - Fax:813-985-0247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-15
Last Update Date:2007-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1154517191OtherNPI