Provider Demographics
NPI:1396177739
Name:ZOE SCRIPTS LABORATORY SERVICES LLC
Entity Type:Organization
Organization Name:ZOE SCRIPTS LABORATORY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RENIER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOBEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-313-6748
Mailing Address - Street 1:4969 VAN DYKE RD.
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558
Mailing Address - Country:US
Mailing Address - Phone:813-374-9988
Mailing Address - Fax:813-374-9989
Practice Address - Street 1:4969 VAN DYKE RD.
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558
Practice Address - Country:US
Practice Address - Phone:813-374-9988
Practice Address - Fax:813-374-9989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory