Provider Demographics
NPI:1841408283
Name:ACCESS MEDICAL LABORATORIES, INC.
Entity Type:Organization
Organization Name:ACCESS MEDICAL LABORATORIES, INC.
Other - Org Name:ACCESS MEDICAL LABS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ELHOSSEINY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:561-745-1233
Mailing Address - Street 1:5151 CORPORATE WAY
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3101
Mailing Address - Country:US
Mailing Address - Phone:561-745-1233
Mailing Address - Fax:866-538-9534
Practice Address - Street 1:5151 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3101
Practice Address - Country:US
Practice Address - Phone:561-745-1233
Practice Address - Fax:866-538-9534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800018670291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL9256OtherBLUE CROSS PROVIDER NO.
FL030751300Medicaid
FL030751300Medicaid