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General NPI Number Information
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NPI Number | 1144752510
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Entity Type | Organization
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Legal Business Name | CAVERY, LLC
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 3031 JASMINE CT
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City | DELRAY BEACH
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State | FL
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Zip | 33483-4701
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Country | US
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Telephone | 646-623-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 3031 JASMINE CT
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City | DELRAY BEACH
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State | FL
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Zip | 33483-4701
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Country | US
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Telephone | 646-623-1020
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AVERY J KNAPP JR.
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Credential |
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Telephone | 646-623-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | A104534
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 2085N0700X
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 20855R0202X
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License Number State | CA
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