Organization
PATH MEDICAL, LLC
Active
Other names
Path Medical -MRI Boca
Organization subpart
No
Provider details
NPI number
Authorized official
ANICIA VICENTE MA (BILLING DIRECTOR)
(407) 399-9070
Entity
Organization
Contact information
Practice address
2900 N MILITARY TRL STE 120, BOCA RATON, FL 33431-6347
(561) 988-7868
(561) 988-7873
Mailing address
6220 S ORANGE BLOSSOM TRL STE 200, ORLANDO, FL 32809-4678
(407) 399-9070
(407) 730-9928
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
HCC11175
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
475580767
475580767
FL
Enumeration date
02/28/2018
Last updated
06/16/2018
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