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NPI Code Detail

MEDICARE: DESTIN REGIONAL IMAGING CENTER LLC

MEDICARE: DESTIN REGIONAL IMAGING CENTER LLC
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
12085R0202XDiagnostic Radiology PhysicianME89464FL
22085R0204XVascular & Interventional Radiology PhysicianME74820FL
32085R0202XDiagnostic Radiology PhysicianME86615FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134116726
Entity Type Code : Organization
Provider Name (Legal Business Name) : DESTIN REGIONAL IMAGING CENTER LLC
Provider Business Mailing Address
First Line : PO BOX 1977
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46206-1977
Country : US
Telephone Number : 855-410-3201
Fax Number : 855-853-5098
Provider Business Practice Location Address
First Line : 7800 US HIGHWAY 98 W
Second Line :
City : MIRAMAR BEACH
State : FL
Zip : 32550-7228
Country : US
Telephone Number : 850-278-3555
Fax Number : 850-278-3562
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : DR. CHUN W CHEN
Credential : MD
Telephone Number : 850-278-3555
Provider Enumeration Date : 09/29/2005
Last Update Date : 05/27/2022

Similar Medicare Providers

1841287547 — DR. BARRY F RIGGS MD
Practice Location Address:
7800 US HIGHWAY 98 W
MIRAMAR BEACH, FL
32550-7228
Practice Phone: 850-278-3555
Practice Fax: 850-278-3562
1427039163 — DR. JOSEPH N ZEMIS M.D.
Practice Location Address:
7800 US HIGHWAY 98 W
MIRAMAR BEACH, FL
32550-7228
Practice Phone: 850-267-1603
Practice Fax: 850-622-3342
1669458246 — CHUN WEN CHEN M.D.
Practice Location Address:
7800 US HIGHWAY 98 W
MIRAMAR BEACH, FL
32550-7228
Practice Phone: 850-278-3556
Practice Fax:
1881665818 — ANTHONY MICHAEL WOOLF M.D.
Practice Location Address:
7800 US HIGHWAY 98 W # ER
MIRAMAR BEACH, FL
32550-7228
Practice Phone: 850-278-3000
Practice Fax: 850-475-4781
1568439883 — DR. ROBERT JAY CROWTHER M.D.
Practice Location Address:
7800 US HIGHWAY 98 W
MIRAMAR BEACH, FL
32550-7228
Practice Phone: 850-278-3552
Practice Fax:
1932178092 — DR. BILLY C WEINSTEIN JR. MD
Practice Location Address:
7800 US HIGHWAY 98 W
MIRAMAR BEACH, FL
32550-7228
Practice Phone: 850-278-3000
Practice Fax:

Directions to “DESTIN REGIONAL IMAGING CENTER LLC ” Practice Location

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