PATH MEDICAL, LLC (NPI# 1467998252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467998252 |
| Entity Type | Organization |
| Organization Name | PATH MEDICAL, LLC |
| Other Organization Name | PATH MEDICAL - EAST |
| Practice Address |
10967 Lake Underhill Rd Ste 120 Orlando FL 32825-4454 |
| Mailing Address |
2304 W Oakland Park Blvd Oakland Park FL 33311-1422 |
| Practice Telephone | 4073673040 |
| Practice Fax Number | 4073673043 |
| Mailing Telephone | 7542182164 |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2019-11-06 |
| Authorized Official Name | DR. NEIL BONNARDEL (DIRECTOR OF MEDICAL SERVICES) |
| Authorized Official Telephone | 7542182164 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | PATH MEDICAL CENTER HOLDINGS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | STATE LICENSE | HCC8601 | 01 |
| Other Name | Type Code |
|---|---|
| Path Medical - East | 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 |
| 1316454788 | Path Medical, LLC | Clinic/Center | 859 Park Ave Ste 102, Orange Park, FL 32073-4151 | 2018-01-06 |
| 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 |
| Street Address |
10967 LAKE UNDERHILL RD STE 120 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32825-4454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881255404 | Planes Dental East Orlando | Clinic/Center | 275 S Chickasaw Trail, Suite 2, Orlando, FL 32825 | 2019-06-25 |
| 1649837550 | Jessica Rivera | Social Worker | 10600 Bloomfield Drive, Apt 918, Orlando, FL 32825 | 2019-05-27 |
| 1326526708 | Total Family Care LLC | Family Medicine | 106 North Dean Road, Suite 1, Orlando, FL 32825 | 2018-07-30 |
| 1285121772 | Neurological Health Associates, L.L.C. | Psychiatry & Neurology | 11602 Lake Underhill Rd., Suite 104, Orlando, FL 32825 | 2018-04-19 |
| 1336636075 | Vijaya Laxmi Telu | Nurse Practitioner | 100 North Dean Rd Suite 101, Orlando, FL 32825 | 2018-04-18 |
| 1740795053 | Anna Louise Morris | Specialist/Technologist | 10719 Fairhaven Way, Orlando, FL 32825 | 2017-12-08 |
| 1568973352 | Darrenn G Cadet | Behavior Technician | 11121 Tortuga Bnd, Orlando, FL 32825 | 2017-10-19 |
| 1265942072 | Raquel B Saliba | Physical Therapist | 250 South Chickasaw Trail, Orlando, FL 32825 | 2017-10-06 |
| 1528585890 | Vreny Tatyana Gonzalez-casas | Behavior Technician | 3206 Mattson Dr, Orlando, FL 32825 | 2017-08-27 |
| 1184147803 | Alexandra Grace Mcmanus | Social Worker | 11258 Point Sylvan Circle, Orlando, FL 32825 | 2017-07-25 |
| Find all providers in zip 32825 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1598373573 | Lifespan Therapy Services Inc | Clinic/Center | 9472 East Colonial Drive, Orlando, FL 32817 | 2020-07-16 |
| 1043837834 | The Critical Care and Hospital Medicine Group, Pllc | Clinic/Center | 2600 University Acres Dr, Orlando, FL 32817-3024 | 2020-06-29 |
| 1548896822 | Aba Therapy Centers of Excellence Corp | Clinic/Center | 1800 Pembrook Dr Ste 372, Orlando, FL 32810-6928 | 2020-03-18 |
| 1033756374 | Obt Chiropractic Inc | Clinic/Center | 7130 S Orange Blossom Trl, Orlando, FL 32809-5755 | 2019-12-05 |
| 1689210858 | Promed Associates LLC | Clinic/Center | 7642 Blue Quail Ln, Orlando, FL 32835-5815 | 2019-11-22 |
| 1699316760 | Doctors United Group Inc | Clinic/Center | 3300 W Colonial Dr, Orlando, FL 32808-8011 | 2019-09-30 |
| 1649828930 | Orna Aesthetics LLC | Clinic/Center | 6735 Conroy Rd Ste 422, Orlando, FL 32835-3566 | 2019-08-29 |
| 1841842721 | Cigna Onsite Health LLC | Clinic/Center | 2500 W Colonial Dr, Orlando, FL 32804-8005 | 2019-07-11 |
| 1902468077 | Akl Active Inc | Clinic/Center | 1767 Spicebush Ct, Orlando, FL 32828-6847 | 2019-06-28 |
| Find all providers in ORLANDO | ||||
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| 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.