NPIMap

Organization Active NPI

Path Medical, LLC

  • Health Service Clinic/Center
  • Pompano Beach, FL
National Provider Identifier
1407358476
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
HCC11212 Issued in FL
Legal business name
PATH MEDICAL, LLC
Practice address
601 E Sample Rd Ste 102&109
Pompano Beach, FL 33064-4443
Phone
(954) 941-7410
Fax
(954) 941-7441
NPI assigned
Mar 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Ms. Anicia O Vicente, MA
Title
Billing Director
Phone
(407) 367-5160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X HCC11212 FL Primary

Addresses

Primary practice location

601 E Sample Rd Ste 102&109
Pompano Beach, FL 33064-4443

Mailing address

6220 S Orange Blossom TRL Ste 200
Orlando, FL 32809-4678
Phone (407) 367-5160

Other identifiers 1

IdentifierTypeStateIssuer
475580767OtherFLPIP

Other names 1

  • Path Medical - Pompano Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Path Medical LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

601 E Sample Rd
Ste 102109
Deerfield Beach, FL 33064
Phone (954) 941-7410

6220 S Orange Blossom Trl
Ste 200
Orlando, FL 32809

NPI Registry JSON

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1407358476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 S ORANGE BLOSSOM TRL STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328094678",
            "telephone_number": "407-367-5160",
            "fax_number": "407-730-9928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E SAMPLE RD STE 102&109",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330644443",
            "telephone_number": "954-941-7410",
            "fax_number": "954-941-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATH MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "VICENTE",
        "authorized_official_first_name": "ANICIA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "407-367-5160",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "HCC11212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIP",
            "identifier": "475580767",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Path Medical - Pompano",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.