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Organization
VIVID PATHOLOGY PA
Active
Organization
VIVID PATHOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES E FARMER MD (PRESIDENT)
(850) 416-6894
Entity
Organization
Contact information
Practice address
5151 N 9TH AVE, PENSACOLA, FL 32504-8721
(850) 416-6894
(850) 416-5487
Mailing address
5149 N 9TH AVE STE 122, PENSACOLA, FL 32504-8779
(850) 416-2469
(843) 664-4308
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
FL
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
FL
Other
Enumeration date
07/23/2008
Last updated
02/22/2018
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