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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
CLIFTON L. BRIDGES JR. MD (PATHOLOGIST VICE PRESIDENT)
(352) 787-1778
Entity
Organization

Contact information

Practice address
1456 WILLIAMS ST, LEESBURG, FL 34748-3824
(352) 787-1778
Mailing address
5755 HOOVER BLVD, TAMPA, FL 33634-5340
(866) 944-0404

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
L9293
BCBS OF FL
FL
01
P00321165
RAILROAD MEDICARE
FL
Enumeration date
07/05/2006
Last updated
03/27/2008
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