Organization
INNOVATIVE LABORATORYSERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH RAVID MD (PRESIDENT AND OWNER)
(941) 505-2100
Entity
Organization
Contact information
Practice address
2654 SW 32ND PL, SUITE 200, OCALA, FL 34471-7847
(941) 505-1000
(941) 505-6100
Mailing address
713 E MARION AVE, SUITE 1211, PUNTA GORDA, FL 33950-3872
(941) 505-2100
(941) 505-6100
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27702
COLA
FL
Enumeration date
01/17/2017
Last updated
01/17/2017
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