Pathology Services Alliance LLC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

PATHOLOGY SERVICES ALLIANCE LLC

Practice address

732 N 3Rd St
Leesburg, FL 34748-4442

Phone

(352) 787-1778

Fax

(352) 787-1164

NPI assigned

Aug 24, 2009

Organization subpart

Yes

Parent organization

LEESBURG REGIONAL MEDICAL CENTER, INC.As reported in NPPES

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

Authorized official

Name

Mrs. Diane Harden

Title

Chief Financial Officer

Phone

(352) 323-5002

Specialties & licenses 1

Addresses

Part of

LRMC Urgent Care Center

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1306079447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 WILLIAM ST",
            "address_2": "ATTN: LORETTA ROSENBALM",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483824",
            "telephone_number": "352-787-1778",
            "fax_number": "352-787-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 N 3RD ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347484442",
            "telephone_number": "352-787-1778",
            "fax_number": "352-787-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY SERVICES ALLIANCE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEESBURG REGIONAL MEDICAL CENTER, INC.",
        "enumeration_date": "2009-08-24",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "HARDEN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "352-323-5002",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.