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General NPI Number Information
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NPI Number | 1629781752
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Entity Type | Organization
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Legal Business Name | BAKOTIC PATHOLOGY ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/04/2023
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 10770 N 46TH ST STE F200
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City | TAMPA
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State | FL
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Zip | 33617-3468
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Country | US
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Telephone | 855-422-5628
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Fax | 205-579-9387
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Provider Business Mailing Address
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Address Line | 6240 SHILOH RD
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City | ALPHARETTA
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State | GA
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Zip | 30005-8347
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Country | US
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Telephone | 855-422-5628
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Fax | 205-579-9387
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Authorized Official
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Title or Position | CFO
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Name | SCOTT BAKOTIC
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Credential |
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Telephone | 678-965-2822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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