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General NPI Number Information
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NPI Number | 1841487626
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA NUCLEAR MEDICINE
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 4302 ALTON RD STE 100
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2891
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Country | US
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Telephone | 305-672-1931
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Fax |
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Provider Business Mailing Address
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Address Line | 4519 GEORGE RD STE 100
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City | TAMPA
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State | FL
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Zip | 33634-7329
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Country | US
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Telephone | 813-496-1075
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Fax | 813-249-7762
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Authorized Official
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Title or Position | OWNER
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Name | NORMAN PEVSNER
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Credential | MD
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Telephone | 305-672-1931
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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 | ME19375
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License Number State | FL
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