Healthcare Provider Details

I. General information

NPI: 1740051911
Provider Name (Legal Business Name): AMERIPATH FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23450 VIA COCONUT PT
ESTERO FL
34135-1877
US

IV. Provider business mailing address

14275 MIDWAY RD STE 400
ADDISON TX
75001-3661
US

V. Phone/Fax

Practice location:
  • Phone: 888-558-1164
  • Fax:
Mailing address:
  • Phone: 866-697-8378
  • Fax: 610-271-4245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DARREN THOMAS WHEELER
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 702-733-7866