# THE PATHOLOGY GROUP OF NORTHWEST FLORIDA PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205646049
- **Authorized official:** NORTH DAVIS (PRESIDENT)
- **Authorized official phone:** (850) 438-1154

## Contact information

- **Practice address:** 4413 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL 32435-6307
- **Practice address phone:** (850) 920-2065
- **Mailing address:** PO BOX 3093, BOCA RATON, FL 33431-0993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/13/2025
- **Last updated:** 01/13/2025