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General NPI Number Information
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NPI Number | 1134442205
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Entity Type | Organization
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Legal Business Name | FCID FLORIDA, INC.
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 03/03/2010
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Provider Practice Location Address
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Address Line | 1071 PORT MALABAR BLVD NE SUITE 104
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City | PALM BAY
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State | FL
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Zip | 32905-5161
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Country | US
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Telephone | 321-725-0085
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Fax |
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Provider Business Mailing Address
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Address Line | 709 S HARBOR CITY BLVD SUITE 250
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City | MELBOURNE
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State | FL
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Zip | 32901-1938
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Country | US
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Telephone | 321-750-0090
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. DONALD A. BITTAR
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Credential |
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Telephone | 321-750-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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