PATH MEDICAL, LLC (NPI# 1558802579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558802579 |
| Entity Type | Organization |
| Organization Name | PATH MEDICAL, LLC |
| Other Organization Name | PATH MEDICAL - CENTRAL TAMPA |
| Practice Address |
4700 N Habana Ave Ste 100 Tampa FL 33614-7116 |
| Practice Telephone | 8135491515 |
| Practice Fax Number | 8135491516 |
| Mailing Telephone | 8135491515 |
| Mailing Fax Number | 8135491516 |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2017-03-09 |
| Authorized Official Name | ANICIA O VICENTE (BILLING DIRECTOR) |
| Authorized Official Telephone | 4073999070 |
| Is Organization Subpart | Y |
| Parent Organization Name | PATH MEDICAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
HCC8645 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | PIP | 475580767 | 01 |
| Other Name | Type Code |
|---|---|
| Path Medical - Central Tampa | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407358476 | Path Medical, LLC | Clinic/Center | 601 E Sample Rd Ste 102&109, Pompano Beach, FL 33064-4443 | 2018-03-06 |
| 1922500545 | Path Medical, LLC | Clinic/Center | 2900 N Military Trl Ste 120, Boca Raton, FL 33431-6347 | 2018-02-28 |
| 1588162838 | Path Medical, LLC | Clinic/Center | 4255 W Commercial Blvd, Tamarac, FL 33319-3305 | 2018-01-31 |
| 1316454788 | Path Medical, LLC | Clinic/Center | 859 Park Ave Ste 102, Orange Park, FL 32073-4151 | 2018-01-06 |
| 1972010346 | Path Medical, LLC | Clinic/Center | 9119 Merrill Rd Ste 32, Jacksonville, FL 32225-4306 | 2018-01-06 |
| 1477089688 | Path Medical, LLC | Clinic/Center | 6220 S Orange Blossom Trl Ste 606, Orlando, FL 32809-4688 | 2017-05-08 |
| 1609301308 | Path Medical, LLC | Clinic/Center | 809 S Florida Ave, Lakeland, FL 33801-5234 | 2017-05-01 |
| 1639603699 | Path Medical, LLC | Clinic/Center | 131 Patterson Rd, Haines City, FL 33844-7803 | 2017-04-17 |
| 1386185189 | Path Medical, LLC | Clinic/Center | 14824 N Florida Ave Ste A, Tampa, FL 33613-1844 | 2017-03-13 |
| 1518408533 | Path Medical, LLC | Clinic/Center | 3140 34th St N, St Petersburg, FL 33713-2404 | 2017-03-09 |
| Street Address |
4700 N HABANA AVE STE 100 |
| City | TAMPA |
| State | FL |
| Zip Code | 33614-7116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134733082 | Robin Rollena Stewart | Home Health | 9537 Lazy Lane, Apt 302, Tampa, FL 33614 | 2020-09-08 |
| 1346885761 | David Joseph Page | Nurse Practitioner | St. Joseph's Behavioral Health Center, 4918 N. Habana Ave, Tampa, FL 33614 | 2019-11-08 |
| 1134687411 | Ramon Chang Adult Family Care Home LLC | Custodial Care Facility | 2607 W Humphrey St, Tampa, FL 33614 | 2019-03-06 |
| 1134600612 | Senior Point Assisted Living Facility, LLC | Assisted Living Facility | 2940 W Hillsborough Ave, Tampa, FL 33614 | 2018-08-23 |
| 1306361266 | Larry Valdes | Assisted Living Facility | 4402 W Minnehaha St, Tampa, FL 33614 | 2017-08-11 |
| 1982128062 | Jaime F Casellas Md Corp | Internal Medicine | 4600 N Habana Ave Suit #13, Tampa, FL 33614 | 2017-07-31 |
| 1891219119 | Waveney Gittens-williams | Alzheimer Center (Dementia Center) | 3706 W. Idle Wild Cir #203, Tampa, FL 33614 | 2017-07-28 |
| 1750811857 | Syerita Nicole Morris | Counselor | 6800 N Dale Marby Hwy, Ste 164, Tampa, FL 33614 | 2017-06-13 |
| 1447786124 | Lisa Moy | Case Manager/Care Coordinator | 4001 W. Dr. Martin Luther King Jr. Blvd., Tampa, FL 33614 | 2017-05-02 |
| 1750813804 | Joshua Martin Good | Physical Therapy Assistant | 3363 W. Waters Avenue, Suite 700, Tampa, FL 33614 | 2017-03-29 |
| Find all providers in zip 33614 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386185189 | Path Medical, LLC | Clinic/Center | 14824 N Florida Ave Ste A, Tampa, FL 33613-1844 | 2017-03-13 |
| 1780062919 | Memorial Medical Center Inc | Clinic/Center | 8001 N Dale Mabry Hwy Ste 501, Tampa, FL 33614-3265 | 2015-05-07 |
| 1306233002 | Sensational Rehab, LLC | Clinic/Center | 204 E Hanna Ave, Tampa, FL 33604-6719 | 2015-04-20 |
| 1245509751 | Cypress Wellness and Spa, Inc. | Clinic/Center | 3249 W Cypress St, Suite C, Tampa, FL 33607-5153 | 2011-12-29 |
| 1265755656 | Columbus Health Care | Clinic/Center | 3434 W Columbus Dr Ste 204, Tampa, FL 33607-1858 | 2010-03-12 |
| 1750613055 | Westport Holdings Tampa, Limited Partnership | Clinic/Center | 12401 N 22nd St, Tampa, FL 33612-4670 | 2010-02-11 |
| 1629307079 | American Rehab Clinic Inc | Clinic/Center | 4006 N Habana Ave, Suite 12, Tampa, FL 33614 | 2009-12-14 |
| 1639407638 | Lissmart Rehabilitation of Tampa,inc | Clinic/Center | 8130 W Waters Ave, 130, Tampa, FL 33615-1821 | 2009-12-02 |
| 1508199175 | Park Place Therapy,llc | Clinic/Center | 6802 N Armenia Ave Ste A, Tampa, FL 33604-5776 | 2009-09-14 |
| 1740421627 | Ameri Rehab LLC. | Clinic/Center | 3601 W Kennedy Blvd, Suite E., Tampa, FL 33609-2850 | 2009-03-23 |
| Find all providers in TAMPA | ||||
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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.