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NPI Code Detail

MEDICARE: NEO PET II, LLC

MEDICARE: NEO PET II, 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
1261QR0208XMobile Radiology Clinic/Center0902-ICOH

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 : 1861443574
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEO PET II, LLC
Provider Business Mailing Address
First Line : 7650 FIRST PL
Second Line : SUITE B
City : OAKWOOD VILLAGE
State : OH
Zip : 44146-6713
Country : US
Telephone Number : 440-439-5145
Fax Number :
Provider Business Practice Location Address
First Line : 5260 SMITH RD
Second Line :
City : BROOKPARK
State : OH
Zip : 44142-1747
Country : US
Telephone Number : 216-267-7380
Fax Number :
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. FLORO MIRALDI
Credential : M.D.
Telephone Number : 440-439-5145
Provider Enumeration Date : 05/15/2006
Last Update Date : 07/10/2008

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Directions to “NEO PET II, LLC ” Practice Location

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