Organization
PATH MEDICAL, LLC
Active
Other names
Path Medical - Pompano
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANICIA O VICENTE MA (BILLING DIRECTOR)
(407) 367-5160
Entity
Organization
Contact information
Practice address
601 E SAMPLE RD STE 102&109, POMPANO BEACH, FL 33064-4443
(954) 941-7410
(954) 941-7441
Mailing address
6220 S ORANGE BLOSSOM TRL STE 200, ORLANDO, FL 32809-4678
(407) 367-5160
(407) 730-9928
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
HCC11212
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
475580767
PIP
FL
Enumeration date
03/06/2018
Last updated
06/16/2018
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