| NPI | 1639318637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD ANTHONY NIEDZWIECKI President/Shareholder 727-791-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME0070649) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: FL ME81474) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME0070649) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME81474) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: FL ME0070649) | |
| 363A00000X Physician Assistant (Licence: FL PAT9104325) | |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2015-05-29 |