Organization Active NPI

Freepath PL

  • Clinical & Laboratory Dermatological Immunology Physician
  • Tampa, FL
National Provider Identifier
1689867418
Registry record updated Aug 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical & Laboratory Dermatological Immunology PhysicianTaxonomy code 207NI0002X
Legal business name
FREEPATH PL
Practice address
4412 W Osborne Ave
Tampa, FL 33614-6963
Phone
(239) 278-1155
NPI assigned
Aug 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2007

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

Authorized official

Name
Judi Richardson
Title
Controller
Phone
(239) 278-1155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical & Laboratory Dermatological Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207NI0002X Primary

Addresses

Primary practice location

4412 W Osborne Ave
Tampa, FL 33614-6963

Mailing address

4412 W Osborne Ave
Tampa, FL 33614-6963
Phone (239) 278-1155

National Provider Directory

National Provider Directory

Locations

9340 N 56th St
Ste 220
Temple Terrace, FL 33617
Phone (813) 914-9100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187913600000",
    "number": "1689867418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4412 W OSBORNE AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146963",
            "telephone_number": "239-278-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4412 W OSBORNE AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146963",
            "telephone_number": "239-278-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEPATH PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2007-08-24",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "JUDI",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "239-278-1155"
    },
    "taxonomies": [
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; 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.