Healthcare Provider Details

I. General information

NPI: 1508546557
Provider Name (Legal Business Name): PATHWAY PT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1537 OAK PARK AVE
SARASOTA FL
34237-3049
US

IV. Provider business mailing address

1537 OAK PARK AVE
SARASOTA FL
34237-3049
US

V. Phone/Fax

Practice location:
  • Phone: 941-310-4155
  • Fax:
Mailing address:
  • Phone: 941-278-6021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: CARLOS LORENZO ACUTIN
Title or Position: PRESIDENT / OWNER
Credential: PTA
Phone: 786-270-6853