Healthcare Provider Details

I. General information

NPI: 1609702893
Provider Name (Legal Business Name): NEUROPATH DX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 SW 60TH STREET RD APT 2005
OCALA FL
34474-4710
US

IV. Provider business mailing address

5101 SW 60TH STREET RD APT 2005
OCALA FL
34474-4710
US

V. Phone/Fax

Practice location:
  • Phone: 956-624-3317
  • Fax:
Mailing address:
  • Phone: 956-624-3317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES J GONZALEZ
Title or Position: OWNER
Credential:
Phone: 956-624-3317