NPIMap

Organization Active NPI

Path Medical, LLC

  • Rehabilitation Clinic/Center
  • Longwood, FL
National Provider Identifier
1740726538
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
HCC7962 Issued in FL
Legal business name
PATH MEDICAL, LLC
Practice address
851 E State Road 434 Ste 126
Longwood, FL 32750-5364
Phone
(407) 379-1330
Fax
(407) 379-1335
NPI assigned
Jan 17, 2017
Organization subpart
Yes
Parent organization
PATH MEDICAL CENTER HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Authorized official

Name
Dr. Neil Bonnardel, MD
Title
Director of Medical Services
Phone
(754) 218-2164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X HCC7962 FL Primary

Addresses

Primary practice location

851 E State Road 434 Ste 126
Longwood, FL 32750-5364

Mailing address

2304 W Oakland Park Blvd
Oakland Park, FL 33311-1422
Phone (754) 218-2164

Other names 1

  • Path Medical - Longwood Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Path Medical LLC24 organizations share this tax ID, including this one
Part of
Path Medical LLC

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

851 E State Road 434
Ste 126
Longwood, FL 32750
Phone (407) 379-1330

NPI Registry JSON

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567987200000",
    "number": "1740726538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 W OAKLAND PARK BLVD",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111422",
            "telephone_number": "754-218-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 E STATE ROAD 434 STE 126",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505364",
            "telephone_number": "407-379-1330",
            "fax_number": "407-379-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATH MEDICAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATH MEDICAL CENTER HOLDINGS, INC.",
        "enumeration_date": "2017-01-17",
        "last_updated": "2019-09-09",
        "status": "A",
        "authorized_official_last_name": "BONNARDEL",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "DIRECTOR OF MEDICAL SERVICES",
        "authorized_official_telephone_number": "754-218-2164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "FL",
            "license": "HCC7962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Path Medical - Longwood",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Path Medical - Longwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.