| NPI | 1710571153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL SLADE Contract Liaison Manager 407-738-4085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology |
| 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 | 2021-02-25 |
| Last Update Date | 2024-03-12 |