Diagnostic Pathology Associates PA

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

DIAGNOSTIC PATHOLOGY ASSOCIATES PA

Practice address

1456 Williams St
Leesburg, FL 34748-3824

Phone

(352) 787-1778

NPI assigned

Jul 5, 2006

Organization subpart

Yes

Parent organization

DIAGNOSTIC PATHOLOGY ASSOCIATES PAAs reported in NPPES

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

Authorized official

Name

Clifton L. Bridges Jr., MD

Title

Pathologist Vice President

Phone

(352) 787-1778

Specialties & licenses 1

Addresses

Other identifiers 2

Part of

Diagnostic Pathology Assoc

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1679504351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5755 HOOVER BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336345340",
            "telephone_number": "866-944-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 WILLIAMS ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483824",
            "telephone_number": "352-787-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC PATHOLOGY ASSOCIATES PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIAGNOSTIC PATHOLOGY ASSOCIATES PA",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PATHOLOGIST VICE PRESIDENT",
        "authorized_official_telephone_number": "352-787-1778",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "L9293",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00321165",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachelle Desir
• Tina Marie Deveau, MS, LMHC
• Shireen Dhanani, D.M.D.
• Diagnostic Outpatient Centers II Inc
• Diagnostic Pathology Associates PA
• Dialysis Care Center Leesburg LLC
• Vanessa I Diaz-Cruz, MD
• Jose L Diaz, MD
• Rosendo Diego Diaz, M.D.
• Tanya I Diaz, MD

• Clinical Medical Laboratory in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.