Organization
MID-FLORIDA PATHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GILMAR TADIOTO (CFO)
(352) 460-0292
Entity
Organization
Contact information
Practice address
120 E NORTH BLVD STE 102, LEESBURG, FL 34748-5241
(352) 460-0292
Mailing address
120 E NORTH BLVD STE 102, LEESBURG, FL 34748-5241
(352) 460-0292
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006243500
—
FL
Enumeration date
08/18/2015
Last updated
08/15/2022
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