| NPI | 1467409631 |
|---|---|
| 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 | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2007-10-17 |