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General NPI Number Information
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NPI Number | 1093925174
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Entity Type | Organization
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Legal Business Name | SUMMIT DIAGNOSTIC CORP.
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1499 FOREST HILL BLVD SUITE 108
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-6050
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Country | US
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Telephone | 561-676-9746
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Fax |
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Provider Business Mailing Address
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Address Line | 8381 BUTLER GREENWOOD DR
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-4539
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Country | US
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Telephone | 561-676-9746
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOHN SPRANKLE
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Credential |
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Telephone | 561-676-9746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | RN3211112
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License Number State | FL
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