MEDICARE: BRITON WILLIAM NEALEY RDMS, RDCS, RVT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471S1302X	Sonography Radiologic Technologist	129103
2	2471V0105X	Vascular Sonography Radiologic Technologist	129103

General Provider Information

NPI Number	:	1114419264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITON WILLIAM NEALEY RDMS, RDCS, RVT

Provider Business Mailing Address
First Line	:	1971 W LUMSDEN RD STE 106
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-8820
Country	:	US
Telephone Number	:	813-549-7820
Fax Number	:	813-549-7823

Provider Business Practice Location Address
First Line	:	1971 W LUMSDEN RD STE 106
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-8820
Country	:	US
Telephone Number	:	813-549-7820
Fax Number	:	813-549-7823

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2018
Last Update Date	:	06/05/2018

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