MID-FLORIDA PATHOLOGY LLC (NPI# 1265798870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265798870 |
| Entity Type | Organization |
| Organization Name | MID-FLORIDA PATHOLOGY LLC |
| Practice Address |
2100 Prevatt St Eustis FL 32726-6130 |
| Mailing Address |
Po Box 490940 Leesburg FL 34749-0940 |
| Practice Telephone | 3523058903 |
| Practice Fax Number | 3524600785 |
| Mailing Telephone | 3524600292 |
| Mailing Fax Number | 3524600785 |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2020-02-28 |
| Authorized Official Name | DR. JAMES KYLE ALLEN II (DIRECTOR) |
| Authorized Official Telephone | 3524600292 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZC0500X |
Pathology Specialization: Cytopathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZD0900X |
Pathology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZH0000X |
Pathology Specialization: Hematology |
Allopathic & Osteopathic Physicians | ||
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 120 E North Blvd Ste 102, Leesburg, FL 347485241 | 3524600292 | 3524600785 |
| 125 Sw 7th St, Williston, FL 326962403 | 3523088903 | 3524600785 |
| 9350 Bay Plaza Blvd Ste 120-26, 27, Tampa, FL 33619 | 3523088903 | 3524600785 |
| Street Address |
2100 PREVATT ST |
| City | EUSTIS |
| State | FL |
| Zip Code | 32726-6130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902885999 | Martin R Austria | Pathology | 2100 Prevatt St, Eustis, FL 32726-6130 | 2006-01-10 |
| 1891816674 | Susan Kim Holland | Dermatology | 2100 Prevatt St, Eustis, FL 32726-6130 | 2007-04-02 |
| 1891754917 | Mario Blanco | Pathology | 2100 Prevatt St, Eustis, FL 32726-6130 | 2006-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508497637 | Alton Emory Kinlaw | Pharmacist | 99 Hillside Drive, Eustis, FL 32726 | 2020-01-28 |
| 1053833426 | Nalia Elizabeth Alicea | Behavioral Analyst | 949 Marietta Lane, Eustis, FL 32726 | 2017-07-07 |
| 1760840938 | Beautiful Angels LLC | Exclusive Provider Organization | 2208 Virginia Avenue, Eustis, FL 32726 | 2016-02-03 |
| 1902274624 | Breakthrough Transitions LLC | Social Worker | 2201 S. Bay Street, Suite B-2, Eustis, FL 32726 | 2015-09-11 |
| 1104223916 | Integrative Physical Medicine of Mount Dora LLC | Specialist | 2818 S Bay St, Eustis, FL 32726 | 2014-11-21 |
| 1154763290 | Irina N Krasilova | Pharmacist | 1950 Sr 19 N, Eustis, FL 32726 | 2013-07-17 |
| 1063773679 | Mangalmurti LLC | Pharmacy | 17435 Us Highway 441, Suite-102, Eustis, FL 32726 | 2012-05-31 |
| 1477813806 | My Darling Angels Home Companion Services | Private Vehicle | 102 Morningview Dr, Eustis, FL 32726 | 2012-05-18 |
| 1801166186 | Akhlaqus Chowdhury | Pharmacist | 2005 North Sr 19, Eustis, FL 32726 | 2012-01-04 |
| 1316269244 | Kamlesh Patel | Pharmacist | 2705 Cotton Ct, Eustis, FL 32726 | 2010-02-19 |
| Find all providers in zip 32726 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053630996 | Edward Donald Mcdade Jr. | Pathology | 19045 Lake Swatara Dr, Eustis, FL 32736-7709 | 2010-05-18 |
| 1902885999 | Martin R Austria | Pathology | 2100 Prevatt St, Eustis, FL 32726-6130 | 2006-01-10 |
| 1891754917 | Mario Blanco | Pathology | 2100 Prevatt St, Eustis, FL 32726-6130 | 2006-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780157321 | Richard Freij | Pathology | 9770 S Military Trl # B4-255, Boynton Beach, FL 33436-3207 | 2019-01-07 |
| 1447755137 | Brian Steven Mccarthy I | Pathology | 1719 Nw 23rd Ave Apt 1f, Gainesville, FL 32605-3005 | 2018-03-26 |
| 1841716123 | Kritika Krishnamurthy | Pathology | 4300 Alton Rd Ste 2400, Miami Beach, FL 33140-2948 | 2017-08-17 |
| 1982154167 | Johnny Paul Hughes | Pathology | 18317 Cypress Stand Cir, Tampa, FL 33647-1816 | 2016-10-11 |
| 1154870657 | Clinical Toxicology Pa | Pathology | 10269 Sw Village Pkwy, 102, Port Saint Lucie, FL 34987-2369 | 2016-09-25 |
| 1932584281 | Nichole Allen | Pathology | 2210 Marsh View Dr Unit 104, Wesley Chapel, FL 33544-4712 | 2015-07-29 |
| 1710368501 | Archi Patel | Pathology | 18311 Highwoods Preserve Pkwy Unit 6413, Tampa, FL 33647-1925 | 2015-06-17 |
| 1265839377 | Hugo Keiji Kaneku Nagahama | Pathology | 1600 Nw 10th Ave Rm 8149, Miami, FL 33136-1015 | 2014-12-04 |
| 1508278532 | Daniel Sanchez | Pathology | 7000 Sw 62nd Ave Ste 601, South Miami, FL 33143 | 2014-05-26 |
| 1508277799 | Kyle White | Pathology | 7188 Estero Dr, Lake Worth, FL 33463-5600 | 2014-05-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.