| NPI | 1407686777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R DETELICH CEO 850-878-4127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Enumeration Date | 2024-08-02 |
| Last Update Date | 2024-08-02 |