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General NPI Number Information
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NPI Number | 1275933491
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Entity Type | Organization
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Legal Business Name | NUKE ME, PA
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 08/25/2014
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Provider Practice Location Address
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Address Line | 821 SAND DOLLAR DR
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City | SANIBEL
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State | FL
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Zip | 33957-7005
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Country | US
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Telephone | 239-823-0057
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Fax |
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Provider Business Mailing Address
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Address Line | 821 SAND DOLLAR DR
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City | SANIBEL
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State | FL
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Zip | 33957-7005
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT J MCDONALD
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Credential | MD
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Telephone | 239-325-2086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | ME51842
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | ME51842
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License Number State | FL
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