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General NPI Number Information
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NPI Number | 1700730850
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Entity Type | Organization
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Legal Business Name | PRIMARY PATHWAY HEALTH PLLC
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Dates
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Enumeration Date | 02/25/2026
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 2367 EL MARRA DR
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City | OCOEE
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State | FL
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Zip | 34761-8414
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Country | US
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Telephone | 321-399-2486
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Fax | 321-221-5343
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 321-399-2486
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Fax | 321-221-5343
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | BERTINE JEANLAURENT
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Credential | APRN, FNP-BC
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Telephone | 321-399-2486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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