| NPI | 1538333117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FAGIEN COO 813-496-1075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME59548) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: FL ME59548) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: FL ME59548) | |
| 2085N0700X Radiology, Neuroradiology (Licence: FL ME59548) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-06-03 |