Provider Demographics
NPI:1770222051
Name:MY BLOOD WORK, LLC
Entity Type:Organization
Organization Name:MY BLOOD WORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHKOLNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-788-5539
Mailing Address - Street 1:8767 BOYNTON BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472
Mailing Address - Country:US
Mailing Address - Phone:305-788-5539
Mailing Address - Fax:
Practice Address - Street 1:8767 BOYNTON BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472
Practice Address - Country:US
Practice Address - Phone:305-788-5539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory