MAVERICK LABS LLC NPI 1811439433

NPI Record

The following NPI record includes the field values provided by the NPPES as well as the field definition as published in the Federal Register. The complete NPI record is also available for download in text, csv and xml formats.

Field Name Field Value Definition 1
NPI 1811439433 The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name MAVERICK LABS LLC The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Other Organization Name OPTUM LABS LLC Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code 4 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Practice Location Address 4601 N CONGRESS AVE SUITE 203 The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name WEST PALM BEACH The date that a record was last updated or changed.
Provider Business Practice Location Address State Name FL The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code 33407 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 5618060990 The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number 5614232495 The fax number associated with the location address of the provider being identified.
Provider Enumeration Date 11/14/2016 The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 11/25/2020 Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Authorized Official Last Name HIRTH The Legal Business Name (LBN) of the parent organization, if the provider is a subpart of a larger entity. This field identifies the official registered name of the parent company or organization under which the provider operates.
Authorized Official First Name JOSHUA The first name of the authorized official.
Authorized Official Title or Position OWNER The title or position of the authorized official.
Authorized Official Telephone Number 5615048343 The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1 291U00000X The last name of the provider. If the provider is an individual, this is the legal name.
Provider License Number 1 800028324 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 1 FL The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 1 Y This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Organization Subpart N Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
NPI Certification Date 11/25/2020 The date on which the National Provider Identifier (NPI) was officially assigned and certified to the provider. This reflects when the provider's NPI record first became active in the NPPES system.

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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