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General NPI Number Information
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NPI Number | 1972820546
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Entity Type | Organization
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Legal Business Name | US RADIOLOGY CENTER, LLC
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Dates
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Enumeration Date | 04/22/2010
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Last Update Date | 04/22/2010
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Provider Practice Location Address
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Address Line | 1879 NIGHTINGALE LANE SUITE A1
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City | TAVARES
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State | FL
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Zip | 32708
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Country | US
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Telephone | 352-401-1919
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Fax |
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Provider Business Mailing Address
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Address Line | 1879 NIGHTINGALE LANE SUITE A1
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City | TAVARES
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State | FL
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Zip | 32708
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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 | MANAGER
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Name | CANDY PAQUETTE
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Credential |
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Telephone | 352-401-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number |
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License Number State |
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