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General NPI Number Information
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NPI Number | 1922017490
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Entity Type | Organization
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Legal Business Name | MD DIAGNOSTIC SPECIALIST, INC
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 668 N ORLANDO AVE SUITE 1010
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City | MAITLAND
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State | FL
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Zip | 32751-4473
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Country | US
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Telephone | 407-740-8848
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Fax |
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Provider Business Mailing Address
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Address Line | 668 N ORLANDO AVE STE 1010
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City | MAITLAND
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State | FL
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Zip | 32751-4460
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AR MANAGER
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Name | BARBARA TATTON
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Credential |
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Telephone | 407-740-8848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | ME90201
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License Number State | FL
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