MEDICARE: SUMMIT DIAGNOSTIC CORP.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency	RN3211112	FL

General Provider Information

NPI Number	:	1093925174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT DIAGNOSTIC CORP.

Provider Business Mailing Address
First Line	:	8381 BUTLER GREENWOOD DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-4539
Country	:	US
Telephone Number	:	561-676-9746
Fax Number	:

Provider Business Practice Location Address
First Line	:	1499 FOREST HILL BLVD
Second Line	:	SUITE 108
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6050
Country	:	US
Telephone Number	:	561-676-9746
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOHN SPRANKLE
Credential	:
Telephone Number	:	561-676-9746

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	08/22/2020

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