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General NPI Number Information
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NPI Number | 1700994910
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Entity Type | Organization
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Legal Business Name | AMERICAN DIAGNOSTIC MEDICINE
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3537 N LECANTO HWY
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-3502
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Country | US
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Telephone | 352-527-9333
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Fax | 352-527-2482
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Provider Business Mailing Address
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Address Line | PO BOX 6465
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City | TITUSVILLE
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State | FL
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Zip | 32782-6465
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Country | US
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Telephone | 352-527-9333
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Fax | 352-527-2482
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Authorized Official
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Title or Position | TECHNOLOGIST/MANAGER
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Name | HECTOR RIVERA
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Credential | RT
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Telephone | 352-527-9333
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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 | HCC5650
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License Number State | FL
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