Provider Demographics
NPI:1912776964
Name:SPIRIT LABORATORY SERVICES
Entity Type:Organization
Organization Name:SPIRIT LABORATORY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORLEY-SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-997-7171
Mailing Address - Street 1:3760 CURTIS BLVD STE 602
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32927-3964
Mailing Address - Country:US
Mailing Address - Phone:321-349-0498
Mailing Address - Fax:321-349-0464
Practice Address - Street 1:3760 CURTIS BLVD STE 602
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32927-3964
Practice Address - Country:US
Practice Address - Phone:321-349-0498
Practice Address - Fax:321-349-0464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory