Organization
LIFE CARE DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA LEE NIELSEN (OWNER)
(727) 522-4433
Entity
Organization
Contact information
Practice address
6320 39TH ST, PINELLAS PARK, FL 33781-6070
(727) 522-4433
(727) 522-3432
Mailing address
PO BOX 40123, ST PETERSBURG, FL 33743-0123
(727) 522-4433
(727) 522-3432
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V2023
BC BS
FL
Enumeration date
03/20/2007
Last updated
04/09/2012
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