Provider Demographics
NPI:1285326934
Name:INSYTE BIOMED LLC
Entity type:Organization
Organization Name:INSYTE BIOMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FABIOLA
Authorized Official - Middle Name:GRACIELA
Authorized Official - Last Name:MARCHENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-454-1418
Mailing Address - Street 1:912 KINGSRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:GOTHA
Mailing Address - State:FL
Mailing Address - Zip Code:34734-4715
Mailing Address - Country:US
Mailing Address - Phone:407-454-1418
Mailing Address - Fax:407-454-1418
Practice Address - Street 1:912 KINGSRIDGE CIR
Practice Address - Street 2:
Practice Address - City:GOTHA
Practice Address - State:FL
Practice Address - Zip Code:34734-4715
Practice Address - Country:US
Practice Address - Phone:407-454-1418
Practice Address - Fax:407-454-1418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory