Organization
PBJ MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN PRUITT MD, PHD (LAB DIRECTOR)
(800) 485-7962
Entity
Organization
Contact information
Practice address
628 MAITLAND AVE, ALTAMONTE SPRINGS, FL 32701-6834
(800) 485-7962
Mailing address
7512 DR PHILLIPS BLVD STE 50, ORLANDO, FL 32819-5420
(800) 485-7962
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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