First Coast Pathology Associates, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

ME 93419 Issued in FL

Legal business name

FIRST COAST PATHOLOGY ASSOCIATES, LLC

Practice address

9421 Waypoint Place
Jacksonville, FL 32257

Phone

(904) 302-3553

NPI assigned

Sep 18, 2015

Organization subpart

No

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

Authorized official

Name

Virendra Desai, MD

Title

Physician

Phone

(904) 302-3553

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442534400000",
    "number": "1700255841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9102 DUCALE WAY APT 204",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334188164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9421 WAYPOINT PLACE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32257",
            "telephone_number": "904-302-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST PATHOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-18",
        "last_updated": "2015-09-18",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "VIRENDRA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "904-302-3553",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "ME 93419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2764806 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• First Coast Medicine PLLC
• First Coast Midwifery Services LLC
• First Coast Nephrology Inc
• First Coast Orthopedic Associates LLC
• First Coast Orthopedic Center, LLC
• First Coast Periodontics, PA
• First Coast Physical Medicine Inc
• First Coast Plastic Surgery PA
• First Coast Podiatric Surgery and Wound Care LLC
• First Coast Podiatry, P a

• Clinical Medical Laboratory in Jacksonville, FL
• Providers in Jacksonville, 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 Sep 18, 2015; 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.