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Active NPI 1205235371 Individual Practitioner Female Practitioner

Idesta Ralph

Technician, Pathology - Phlebotomy • Tyrone, GA

Professional Overview & Biography Verified Profile Summary

Idesta Ralph is a registered healthcare professional specializing in Technician, Pathology - Phlebotomy in Tyrone, GA. Practice services are available at 1015 TYRONE RD # 410-C under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1015 Tyrone Rd # 410-C

Tyrone, GA 302902407

Telephone 4708182264
Fax 8669843729
Associated Practice Facility / Clinic
🏢 Idesta Medical Inc Facility NPI 1063185015

Specialty Benchmarks & Practice Insights

Comparative analytics for Technician, Pathology - Phlebotomy in Tyrone, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 29.0 Yrs
Regional Practice Density
1 Specialists

Practicing in Tyrone, GA (261 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-06-10
Technician, Pathology - Phlebotomy Primary Specialty

NUCC Taxonomy Code: 246RP1900X

State License NY 56083

Definition to come...

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location June 10, 2026

Registered at 1015 TYRONE RD # 410-C, TYRONE, GA 302902407 (Tel: 4708182264)

📍
Updated Practice Location October 16, 2024

Registered at 5530 OLD NATIONAL HWY BLDG 5530-B2, COLLEGE PARK, GA 303493356 (Tel: 4708182264)

📍
Updated Business Mailing Address October 16, 2024

Registered at 5530 OLD NATIONAL HWY BLDG 5530-B2, COLLEGE PARK, GA 303496234 (Tel: 4708182264)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 16, 2024

Technician, Pathology (License #56083 in NY)

📍
Updated Practice Location July 27, 2021

Registered at 4827 OLD NATIONAL HWY UNIT 2032, COLLEGE PARK, GA 303376234 (Tel: 2398957910)

📍
Updated Business Mailing Address July 27, 2021

Registered at 4827 OLD NATIONAL HWY UNIT 2032, COLLEGE PARK, GA 303376234 (Tel: 2398957910)

👤
Provider Name / Credentials Updated July 27, 2021

Recorded as IDESTA RALPH

NPI Profile Active August 14, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location August 14, 2014

Registered at 1846 NE 23RD ST, CAPE CORAL, FL 339094673 (Tel: 2392973236)

📍
Updated Business Mailing Address August 14, 2014

Registered at 1846 NE 23RD ST, CAPE CORAL, FL 339094673 (Tel: 2392973236)

👤
Provider Name / Credentials Updated August 14, 2014

Recorded as IDESTA RALPH, PHLEBOTOMY TECHNOLOG

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 14, 2014

Technician, Pathology (License #0326943231 in NY)

🟢
Initial NPI Registration & Enumeration August 14, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1205235371
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 14, 2014
Last Update: June 10, 2026
Sole Proprietor: Yes

Mailing Address

5530 Old National Hwy Bldg 5530-B2

College Park, GA 303496234

Phone: 4708182264

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.