Provider Demographics
NPI:1821736422
Name:STAT CONSULTANTS
Entity Type:Organization
Organization Name:STAT CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOATES
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:941-227-0791
Mailing Address - Street 1:PO BOX 522
Mailing Address - Street 2:
Mailing Address - City:MYAKKA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34251-0522
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:888-775-8891
Practice Address - Street 1:216 E MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-4313
Practice Address - Country:US
Practice Address - Phone:941-227-0791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care