Organization
DIAGNOSTIC PATHOLOGY ASSOCIATES PA
Active
Parent organization
DIAGNOSTIC PATHOLOGY ASSOCIATES PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIAGNOSTIC PATHOLOGY ASSOCIATES PA
Authorized official
DR. CLIFTON L BRIDGES JR. MD (MD PRESIDENT)
(352) 323-5300
Entity
Organization
Contact information
Practice address
600 E DIXIE AVE, LEESBURG, FL 34748-5925
(352) 323-5300
Mailing address
5755 HOOVER BLVD, TAMPA, FL 33634-5340
(866) 944-0404
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94814
BCBS OF FL
FL
01
—
DD0960
RAILROAD MEDICARE
—
Enumeration date
07/15/2005
Last updated
03/27/2008
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