Healthcare Provider Details

I. General information

NPI: 1205669538
Provider Name (Legal Business Name): WE SCAN DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E PARK AVE
CHIEFLAND FL
32626-0901
US

IV. Provider business mailing address

382 NE 191ST ST # 455710
MIAMI FL
33179-3899
US

V. Phone/Fax

Practice location:
  • Phone: 352-425-9846
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE MALLEY
Title or Position: OWNER
Credential:
Phone: 352-423-9846