Provider Demographics
NPI:1124615935
Name:ANGEL HANDS PHLEBOTOMY SERVICES, LLC
Entity type:Organization
Organization Name:ANGEL HANDS PHLEBOTOMY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTAVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:NCMA
Authorized Official - Phone:407-410-8590
Mailing Address - Street 1:PO BOX 616985
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6985
Mailing Address - Country:US
Mailing Address - Phone:407-410-8590
Mailing Address - Fax:321-250-8505
Practice Address - Street 1:3508 RHAPSODY ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34772-8256
Practice Address - Country:US
Practice Address - Phone:407-410-8590
Practice Address - Fax:321-250-8505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty