is a Vascular & Interventional Radiology in , . practices all healthcare services and medical treatments related to Vascular & Interventional Radiology. The NPI Number for is 1003868522. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
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| Address | , , |
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| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1003868522 |
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| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
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| City | |
| State | () |
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Provider's Primary Taxonomy Detail
| Speciality | Vascular & Interventional Radiology |
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| Taxonomy | 2085R0204X |
| Licence No | ME82080 |
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Definition: A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 239216 | FL | AVMED | |
| P00316743 | FL | RAIL ROAD MEDICARE | |
| P00316743 | FL | RAILROAD MEDICARE | |
| P00323927 | FL | RAIL ROAD MEDICARE | |
| 57945 | FL | BCBS FL | |
| 57945 | FL | BCBSFL | |
| P00323927 | FL | RAILROAD MEDICARE | |
| 266536100 | FL | -- | |
| 270855 | FL | AVMED |
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