MEDICARE: DIVINE PATH NEMT, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1407781875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINE PATH NEMT, LLC

Provider Business Mailing Address
First Line	:	15823 CEDAR ELM TER
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-3741
Country	:	US
Telephone Number	:	813-810-2773
Fax Number	:	813-810-2773

Provider Business Practice Location Address
First Line	:	6001 JOHNS RD STE 510
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-4501
Country	:	US
Telephone Number	:	813-810-2773
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DENISE PEREZ
Credential	:	PEREZ
Telephone Number	:	813-810-2773

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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Directions to “DIVINE PATH NEMT, LLC ” Practice Location

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