Provider Demographics
NPI:1427733955
Name:ASSURESTICK PHLEBOTOMY & TRAINING SERVICES
Entity type:Organization
Organization Name:ASSURESTICK PHLEBOTOMY & TRAINING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PHLEBOTOMIST
Authorized Official - Prefix:
Authorized Official - First Name:SHARIEA
Authorized Official - Middle Name:
Authorized Official - Last Name:WIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-278-8578
Mailing Address - Street 1:9200 NW 39TH AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-7366
Mailing Address - Country:US
Mailing Address - Phone:352-278-8578
Mailing Address - Fax:
Practice Address - Street 1:3306 SE 23RD AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32641-7366
Practice Address - Country:US
Practice Address - Phone:352-278-8578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory