NPIMap

Organization Active NPI

Path Medical, LLC

  • Clinic/Center
  • West Palm Beach, FL
National Provider Identifier
1285178665
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PATH MEDICAL, LLC
Practice address
2001 Palm Beach Lakes Blvd Ste 101
West Palm Beach, FL 33409-6513
Phone
(561) 240-6584
Fax
(561) 437-4142
NPI assigned
Dec 5, 2016
Organization subpart
Yes
Parent organization
PATH MEDICAL CENTER HOLDINGS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Neil Bonnardel, MD
Title
Director of Medical Services
Phone
(754) 218-2164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2001 Palm Beach Lakes Blvd Ste 101
West Palm Beach, FL 33409-6513

Mailing address

2304 W Oakland Park Blvd
Oakland Park, FL 33311-1422
Phone (754) 218-2164

Other practice location 1

2300 Glades Rd
Suite 200E
Boca Raton, FL 33431-7386
Phone (561) 392-9002

Other names 2

  • Path Medical - Palm Beach Lakes Doing business as
  • Path Medical- Boca Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Path Medical LLC24 organizations share this tax ID, including this one
Part of
Path Medical LLC

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582848000000",
    "number": "1285178665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 W OAKLAND PARK BLVD",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111422",
            "telephone_number": "754-218-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 PALM BEACH LAKES BLVD STE 101",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096513",
            "telephone_number": "561-240-6584",
            "fax_number": "561-437-4142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Glades Rd",
            "address_2": "Suite 200E",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334317386",
            "country_code": "US",
            "telephone_number": "561-392-9002",
            "fax_number": "561-554-1030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PATH MEDICAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATH MEDICAL CENTER HOLDINGS, INC",
        "enumeration_date": "2016-12-05",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A",
        "authorized_official_last_name": "BONNARDEL",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "DIRECTOR OF MEDICAL SERVICES",
        "authorized_official_telephone_number": "754-218-2164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Path Medical - Palm Beach Lakes",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Path Medical- Boca",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Path Medical- Boca",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.