| NPI | 1730751439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDY JORDAN Credentialing Specialist 321-206-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2021-07-13 |