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General NPI Number Information
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NPI Number | 1417953852
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Entity Type | Organization
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Legal Business Name | WEST FLORIDA PET SERVICES LLC
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 427 SOUTH PARSONS AVE SUITE 101
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City | BRANDON
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State | FL
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Zip | 33511-5980
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Country | US
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Telephone | 813-315-2080
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Fax | 813-315-2090
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Provider Business Mailing Address
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Address Line | 427 SOUTH PARSONS AVE SUITE 101
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City | BRANDON
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State | FL
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Zip | 33511-5980
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Country | US
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Telephone | 813-315-2080
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Fax | 813-315-2090
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Authorized Official
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Title or Position | SENIOR VP
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Name | MR. WILLIAM B. RUTHERFORD
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Credential |
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Telephone | 615-309-2190
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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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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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Taxonomy #3
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0207X
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Taxonomy Name | Mobile Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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