Healthcare Provider Details

I. General information

NPI: 1649133240
Provider Name (Legal Business Name): OXYGEN PATH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6480 N COUNTY ROAD 53
MAYO FL
32066-2629
US

IV. Provider business mailing address

6480 N COUNTY ROAD 53
MAYO FL
32066-2629
US

V. Phone/Fax

Practice location:
  • Phone: 352-222-4748
  • Fax:
Mailing address:
  • Phone: 352-222-4748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL LEE JR.
Title or Position: OWNER
Credential: RRT
Phone: 352-222-4648