Provider Demographics
NPI:1801291794
Name:TPL FL LLC
Entity type:Organization
Organization Name:TPL FL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-312-1252
Mailing Address - Street 1:830 W BAYOU PINES DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-7077
Mailing Address - Country:US
Mailing Address - Phone:337-312-1252
Mailing Address - Fax:
Practice Address - Street 1:5817 N ANDREWS WAY
Practice Address - Street 2:SUITE B
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-2359
Practice Address - Country:US
Practice Address - Phone:954-771-8903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory