Provider Demographics
NPI:1376213454
Name:EXCEL ELITE LABS LLC
Entity Type:Organization
Organization Name:EXCEL ELITE LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHUYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-367-8163
Mailing Address - Street 1:435 E STATE ROAD 434 STE 500
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-5203
Mailing Address - Country:US
Mailing Address - Phone:321-367-8163
Mailing Address - Fax:321-972-8114
Practice Address - Street 1:435 E STATE ROAD 434 STE 500
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5203
Practice Address - Country:US
Practice Address - Phone:321-367-8163
Practice Address - Fax:321-972-8114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory