Provider Demographics
NPI:1982852992
Name:NATIONAL HEALTH SCREEN LLC
Entity Type:Organization
Organization Name:NATIONAL HEALTH SCREEN LLC
Other - Org Name:HEALTH & WELLNESS PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:ABDISHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-669-4551
Mailing Address - Street 1:12425 28TH STREET N
Mailing Address - Street 2:STE 304
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716
Mailing Address - Country:US
Mailing Address - Phone:727-669-4551
Mailing Address - Fax:727-669-2420
Practice Address - Street 1:12425 28TH STREET N
Practice Address - Street 2:STE 101
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716
Practice Address - Country:US
Practice Address - Phone:727-669-4551
Practice Address - Fax:727-669-2420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251K00000X, 251S00000X, 261QC1800X, 261QH0100X, 305S00000X
FL800018825291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No291U00000XLaboratoriesClinical Medical Laboratory
No305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL800018825OtherHEALTHCARE CLINIC ESTABLISHMENT
FL10D1020546OtherCMS CLIA CERTIFICATE OF WAIVER