PATH MEDICAL, LLC (NPI# 1316454788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316454788 |
| Entity Type | Organization |
| Organization Name | PATH MEDICAL, LLC |
| Other Organization Name | PATH MEDICAL - ORANGE PARK |
| Practice Address |
859 Park Ave Ste 102 Orange Park FL 32073-4151 |
| Mailing Address |
6220 S Orange Blossom Trl Ste 200 Orlando FL 32809-4678 |
| Practice Telephone | 9042787411 |
| Practice Fax Number | 8558312251 |
| Enumeration Date | 2018-01-06 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | ANICIA O VICENTE (BILLING DIRECTO) |
| Authorized Official Telephone | 4073675160 |
| Authorized Official Credential | MA |
| Is Organization Subpart | Y |
| Parent Organization Name | PATH MEDICAL CENTERS HOLDING, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
HCC11223 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | PIP | 475580767 | 01 |
| Other Name | Type Code |
|---|---|
| Path Medical - Orange Park | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407358476 | Path Medical, LLC | Clinic/Center | 601 E Sample Rd Ste 102&109, Pompano Beach, FL 33064-4443 | 2018-03-06 |
| 1922500545 | Path Medical, LLC | Clinic/Center | 2900 N Military Trl Ste 120, Boca Raton, FL 33431-6347 | 2018-02-28 |
| 1588162838 | Path Medical, LLC | Clinic/Center | 4255 W Commercial Blvd, Tamarac, FL 33319-3305 | 2018-01-31 |
| 1972010346 | Path Medical, LLC | Clinic/Center | 9119 Merrill Rd Ste 32, Jacksonville, FL 32225-4306 | 2018-01-06 |
| 1477089688 | Path Medical, LLC | Clinic/Center | 6220 S Orange Blossom Trl Ste 606, Orlando, FL 32809-4688 | 2017-05-08 |
| 1609301308 | Path Medical, LLC | Clinic/Center | 809 S Florida Ave, Lakeland, FL 33801-5234 | 2017-05-01 |
| 1639603699 | Path Medical, LLC | Clinic/Center | 131 Patterson Rd, Haines City, FL 33844-7803 | 2017-04-17 |
| 1386185189 | Path Medical, LLC | Clinic/Center | 14824 N Florida Ave Ste A, Tampa, FL 33613-1844 | 2017-03-13 |
| 1518408533 | Path Medical, LLC | Clinic/Center | 3140 34th St N, St Petersburg, FL 33713-2404 | 2017-03-09 |
| 1891236816 | Path Medical, LLC | Clinic/Center | 1369 Providence Rd, Brandon, FL 33511-4885 | 2017-03-09 |
| Street Address |
859 PARK AVE STE 102 |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-4151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578193504 | Florida Institute of Pain Medicine LLC | Anesthesiology | 859 Park Ave Ste 102, Orange Park, FL 32073-4151 | 2020-01-17 |
| 1275031569 | Path Medical, LLC | Clinic/Center | 859 Park Ave Ste 102, Orange Park, FL 32073-4151 | 2018-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275031569 | Path Medical, LLC | Clinic/Center | 859 Park Ave Ste 102, Orange Park, FL 32073-4151 | 2018-02-01 |
| 1932537776 | Live Well Medical Services, LLC | Clinic/Center | 1409 Kingsley Ave, Building 2, Orange Park, FL 32073-4537 | 2013-10-14 |
| 1376977611 | St. Johns Chiropractic & Nutrition, LLC | Clinic/Center | 35 Knight Boxx Rd, Suite 3, Orange Park, FL 32065-8053 | 2013-08-22 |
| 1013189372 | Starkey Chiropractic Inc | Clinic/Center | 461 Kingsley Ave, Orange Park, FL 32073-4827 | 2008-03-27 |
| 1811193568 | Global Family Care P A | Clinic/Center | 1677 Wells Rd, Suite 'c', Orange Park, FL 32073-6799 | 2007-06-21 |
| 1114914777 | Discover Family Chiropractic Inc | Clinic/Center | 1339 Blanding Blvd, Orange Park, FL 32065-8022 | 2005-09-29 |
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| Find all providers with the same taxonomy | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
Please comment or provide details below to improve the information on PATH MEDICAL, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.