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General NPI Number Information
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NPI Number | 1588896591
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Entity Type | Organization
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Legal Business Name | TREASURE COAST ULTRASOUND CONSULTANTS, INC
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Dates
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Enumeration Date | 08/10/2009
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Last Update Date | 06/02/2011
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Provider Practice Location Address
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Address Line | 850 CENTRAL AVE #305
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City | NAPLES
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State | FL
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Zip | 34102-6030
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Country | US
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Telephone | 239-571-5995
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Fax | 239-775-6661
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Provider Business Mailing Address
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Address Line | 850 CENTRAL AVE #305
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City | NAPLES
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State | FL
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Zip | 34102-6030
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Country | US
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Telephone | 239-571-5995
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Fax | 239-775-6661
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THOMAS GRANT WALKER
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Credential | RADIOLOGIC TECHNOLOG
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Telephone | 239-591-5995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | 14776ARDMS
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License Number State | FL
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