Organization
PATH MEDICAL, LLC
Active
Organization
PATH MEDICAL, LLC
Active
Parent organization
PATH MEDICAL CENTER HOLDINGS, INC.
Other names
Path Medical - Kissimmee
Organization subpart
Yes
Provider details
NPI number
Legal business name
PATH MEDICAL CENTER HOLDINGS, INC.
Authorized official
DR. NEIL BONNARDEL MD (DIRECTOR OF MEDICAL SERVICES)
(754) 218-2164
Entity
Organization
Contact information
Practice address
1040 E OSCEOLA PKWY, KISSIMMEE, FL 34744-1607
(321) 219-1000
(407) 730-9928
Mailing address
2304 W OAKLAND PARK BLVD, OAKLAND PARK, FL 33311-1422
(754) 218-2164
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC8292
STATE LICENSE
FL
Enumeration date
01/17/2017
Last updated
11/06/2019
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