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General NPI Number Information
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NPI Number | 1376780254
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Entity Type | Organization
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Legal Business Name | STUART DIAGNOSTICS CENTER LLC
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 2219 SE OCEAN BLVD
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City | STUART
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State | FL
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Zip | 34996-3307
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Country | US
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Telephone | 772-600-1720
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Fax | 772-600-1724
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Provider Business Mailing Address
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Address Line | 2219 SE OCEAN BLVD
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City | STUART
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State | FL
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Zip | 34996-3307
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Country | US
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Telephone | 772-600-1720
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Fax | 772-600-1724
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Authorized Official
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Title or Position | PRESIDENT
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Name | CAROL WILLIAMS
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Credential |
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Telephone | 772-600-1720
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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 |
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License Number State |
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