Path Medical, Llc
May also be knows as Path Medical- Port St. Lucie
Clinic/Center in Port St Lucie, FL(View on Map)
Legal Business Name
Path Medical, Llc
Also Known As
Path Medical- Port St. Lucie
NPI Number
1003276635
NPI Type
Organization
Enumeration Date
02/24/2016
Specialties
(Taxonomies)Contact
Information
Purpose
Mailing
Location
Address
2304 W OAKLAND PARK BLVD
549 NW LAKE WHITNEY PL STE 101
City
Oakland Park
Port St Lucie
State
FL
FL
Postal Code
33311-1422
34986-1606
Country
US
US
Telephone Number
(754) 218-2164
(772) 732-7874
Authorized Official
Name
Dr. Neil Bonnardel
Title or Position
DIRECTOR OF MEDICAL SERVICES
Telephone Number
(754) 218-2164
Identifiers
Identifier
HCC10776
Identifier State
FL
Identifier Issuer
STATE LICENSE
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 02/05/2021
Provider Address
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