Path Medical, LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

HCC8645 Issued in FL

Legal business name

PATH MEDICAL, LLC

Doing business as

Path Medical - Central Tampa

Practice address

4700 N Habana Ave Ste 100
Tampa, FL 33614-7116

Phone

(813) 549-1515

Fax

(813) 549-1516

NPI assigned

Mar 9, 2017

Organization subpart

Yes

Parent organization

PATH MEDICALAs reported in NPPES

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

Authorized official

Name

Anicia O Vicente

Title

Billing Director

Phone

(407) 399-9070

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Path Medical - Central Tampa Doing business as

Part of

Path Medical LLC

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1558802579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 N HABANA AVE STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147116",
            "telephone_number": "813-549-1515",
            "fax_number": "813-549-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N HABANA AVE STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147116",
            "telephone_number": "813-549-1515",
            "fax_number": "813-549-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATH MEDICAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATH MEDICAL",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "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": "407-399-9070"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "FL",
            "license": "HCC8645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIP",
            "identifier": "475580767",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Path Medical - Central Tampa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brianna Elizabeth Patenaude, LCSW
• Anthony Nicholas Paterra, DO
• Casey Paterson
• Kim Marie Patey, AP
• Path Medical, LLC (Path Medical - North Tampa)
• Path Medical, LLC (Path Medical - Absolute)
• Priya Omprakash Pathak, MD
• Paths Mental Health, LLC
• Pathway Mental Health Services, Inc.
• Pathway of Florida, LLC

• Rehabilitation Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.