Organization
PATH MEDICAL, LLC
Active
Parent organization
PATH MEDICAL
Other names
Path Medical - St. Pete
Organization subpart
Yes
Provider details
NPI number
Legal business name
PATH MEDICAL
Authorized official
DR. NEIL BONNARDEL MD (DIRECTOR OF MEDICAL SERVICES)
(754) 218-2164
Entity
Organization
Contact information
Practice address
3140 34TH ST N, ST PETERSBURG, FL 33713-2404
(727) 471-1100
Mailing address
2304 W OAKLAND PARK BLVD, OAKLAND PARK, FL 33311-1422
(754) 218-2164
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
HCC8800
FL
Other
Enumeration date
03/09/2017
Last updated
09/09/2019
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