Healthcare Provider Details
I. General information
NPI: 1588585616
Provider Name (Legal Business Name): PATHVUE HEALTH HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7790 NW 79TH AVE APT G2
TAMARAC FL
33321-9004
US
IV. Provider business mailing address
2950 W CYPRESS CREEK RD STE 3331013
FORT LAUDERDALE FL
33309-1713
US
V. Phone/Fax
- Phone: 954-670-4523
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARSHA
JUREIDINI
Title or Position: MANAGING MEMBER
Credential: NP
Phone: 954-670-4523