MEDICARE: PATHWAY PT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1508546557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAY PT LLC

Provider Business Mailing Address
First Line	:	1537 OAK PARK AVE
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34237-3049
Country	:	US
Telephone Number	:	941-278-6021
Fax Number	:

Provider Business Practice Location Address
First Line	:	1537 OAK PARK AVE
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34237-3049
Country	:	US
Telephone Number	:	941-310-4155
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT / OWNER
Name	:	CARLOS LORENZO ACUTIN
Credential	:	PTA
Telephone Number	:	786-270-6853

Provider Enumeration Date	:	07/24/2023
Last Update Date	:	04/22/2025

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Directions to “PATHWAY PT LLC ” Practice Location

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