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NPI Code Detail

MEDICARE: SOUTHERN CARDIAC NUCLEAR IMAGING LLC

MEDICARE: SOUTHERN CARDIAC NUCLEAR IMAGING 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
1207UN0901XNuclear Cardiology Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00224933OTHERRAILROAD MEDICARE

General Provider Information

NPI Number : 1982686366
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHERN CARDIAC NUCLEAR IMAGING LLC
Provider Business Mailing Address
First Line : PO BOX 144333
Second Line :
City : ORLANDO
State : FL
Zip : 32814-4333
Country : US
Telephone Number : 407-422-9831
Fax Number : 407-648-2065
Provider Business Practice Location Address
First Line : 6484 FORT CAROLINE RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32277-2042
Country : US
Telephone Number : 352-332-5755
Fax Number : 866-887-9246
Authorized Official
Title or Position : PRESIDENT
Name : FLOYD W. BURKE
Credential : M.D.
Telephone Number : 352-332-8991
Provider Enumeration Date : 11/19/2005
Last Update Date : 01/10/2011

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Directions to “SOUTHERN CARDIAC NUCLEAR IMAGING LLC ” Practice Location

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