Organization
PATH MEDICAL, LLC
Active
Parent organization
PATH MEDICAL CENTER HOLDINGS, INC.
Other names
Path Medical - Apex
Organization subpart
Yes
Provider details
NPI number
Legal business name
PATH MEDICAL CENTER HOLDINGS, INC.
Authorized official
ANICIA O VICENTE MA (DIRECTOR OF BILLING)
(407) 399-9070
Entity
Organization
Contact information
Practice address
6148 HANGING MOSS RD STE 100, ORLANDO, FL 32807-3792
(321) 295-7977
(321) 295-7979
Mailing address
PO BOX 638500, CINCINNATI, OH 45263-8500
(407) 367-5160
(407) 730-9928
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
HCC8985
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
475580767
PIP
FL
Enumeration date
01/17/2017
Last updated
01/17/2017
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