Healthcare Provider Details

I. General information

NPI: 1720700537
Provider Name (Legal Business Name): DLP IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 09/19/2022
Certification Date: 09/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 SOUTHCREEK BLVD
PORT ORANGE FL
32128-7252
US

IV. Provider business mailing address

1951 SOUTHCREEK BLVD
PORT ORANGE FL
32128-7252
US

V. Phone/Fax

Practice location:
  • Phone: 202-907-7363
  • Fax:
Mailing address:
  • Phone: 202-907-7363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PEPPER LAMAR DAY
Title or Position: PRESIDENT
Credential: MD
Phone: 202-907-7363