Organization · Type 2 NPI

Path Medical, LLC

Health Service Clinic/Center · Haines City, FL

NPI number 1639603699 Active

Practice location

131 Patterson Rd
Haines City, FL 33844-7803

Call (407) 367-5160 Map

Fax (407) 730-9928

Mailing address

2304 W Oakland Park Blvd
Oakland Park, FL 33311-1422

Specialties and licenses

Taxonomy	Code	License
Health Service Clinic/Center Primary	261QH0100X	None listed

Health Service Clinic/Center: Definition to come...

NPI record

NPI: 1639603699
Entity type: Organization (Type 2)
Issued: Apr 17, 2017
Last updated: Sep 9, 2019
Status: Active
Subpart: Yes of Path Medical

Other names

<unavail>
Path Medical- Haines City · doing business as
Path Medical- Haines City · doing business as

Authorized official

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

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1639603699

Path Medical, LLC's National Provider Identifier is 1639603699, issued on Apr 17, 2017. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Haines City, FL. The record was last updated on Sep 9, 2019.