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General NPI Number Information
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NPI Number | 1508546557
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Entity Type | Organization
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Legal Business Name | PATHWAY PT LLC
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 1537 OAK PARK AVE
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City | SARASOTA
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State | FL
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Zip | 34237-3049
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Country | US
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Telephone | 941-310-4155
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Fax |
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Provider Business Mailing Address
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Address Line | 1537 OAK PARK AVE
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City | SARASOTA
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State | FL
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Zip | 34237-3049
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Country | US
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Telephone | 941-278-6021
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | CARLOS LORENZO ACUTIN
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Credential | PTA
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Telephone | 786-270-6853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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