| NPI | 1003866773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R DETELICH CEO 850-878-4127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging |
| 2085N0700X Radiology Neuroradiology | |
| 2085N0904X Radiology Nuclear Radiology | |
| 2085P0229X Radiology Pediatric Radiology | |
| 2085R0204X Radiology Vascular & Interventional Radiology | |
| 2085U0001X Radiology Diagnostic Ultrasound | |
| 2471C3401X Radiologic Technologist Computed Tomography | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2014-03-14 |