Provider Demographics
NPI:1538535240
Name:PATH MEDICAL CENTER INC
Entity type:Organization
Organization Name:PATH MEDICAL CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ATLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-735-6584
Mailing Address - Street 1:1016 W HALLANDALE BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5243
Mailing Address - Country:US
Mailing Address - Phone:954-456-0080
Mailing Address - Fax:954-458-9400
Practice Address - Street 1:1016 W HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-5243
Practice Address - Country:US
Practice Address - Phone:954-456-0080
Practice Address - Fax:954-458-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)