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General NPI Number Information
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NPI Number | 1285327395
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Entity Type | Organization
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Legal Business Name | 90 MINUTE DIAGNOSTICS LLC
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Dates
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Enumeration Date | 06/02/2023
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 11903 PANAMA CITY BEACH PKWY # A
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-2605
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Country | US
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Telephone | 850-558-3247
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Fax |
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Provider Business Mailing Address
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Address Line | 6415 LAKE WORTH RD STE 102
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City | GREENACRES
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State | FL
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Zip | 33463-3009
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Country | US
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Telephone | 561-331-0808
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Fax | 561-594-0880
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Authorized Official
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Title or Position | OFFICER
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Name | HUY BAO NGUYEN
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Credential | MD
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Telephone | 681-318-0790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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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 |
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License Number State |
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