Active NPI
Freepath PL
- Clinical & Laboratory Dermatological Immunology Physician
- Tampa, FL
National Provider Identifier
1689867418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical & Laboratory Dermatological Immunology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical & Laboratory Dermatological Immunology Physician | 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 DirectoryLocations
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.
-
- Dermatopathology Physician
- Tampa, FL
- NPI 1013948363
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.