| NPI | 1104079821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE MARIE PACETTI Radiographer 239-939-3939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL 28080) |
| Additional Taxonomies | 261QR0206X Clinic/Center Radiology, Mammography (Licence: FL 168043) |
| Enumeration Date | 2008-10-25 |
| Last Update Date | 2008-10-25 |