# THE PATHOLOGY GROUP OF NORTHWEST FLORIDA PLLC

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

## Provider details

- **NPI number:** 1811694458
- **Authorized official:** NORTH DAVIS (PRESIDENT)
- **Authorized official phone:** (850) 438-1154

## Contact information

- **Practice address:** 2600 HOSPITAL DR, BONIFAY, FL 32425-4264
- **Practice address phone:** (850) 547-8000
- **Mailing address:** PO BOX 3093, BOCA RATON, FL 33431-0993
- **Mailing address phone:** (850) 438-1154

## 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:** 02/14/2023
- **Last updated:** 02/14/2023