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General NPI Number Information
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NPI Number | 1891762910
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Entity Type | Organization
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Legal Business Name | RADIOLOGY ASSOCIATES OF THE TREASURE COAST PA INC
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 08/27/2016
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Provider Practice Location Address
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Address Line | 698 SW PORT ST LUCIE BLVD SUITE 109
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-1565
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Country | US
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Telephone | 772-873-4525
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Fax | 772-873-4121
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Provider Business Mailing Address
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Address Line | PO BOX 71
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City | JENSEN BEACH
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State | FL
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Zip | 34958-0071
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Country | US
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Telephone | 866-263-3820
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Fax | 866-857-9967
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. RONALD BEATON
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Credential | MD
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Telephone | 772-873-4525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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