Fort Walton Diagnostic Imaging Center Llc

LBN: Fort Walton Diagnostic Imaging Center Llc
Fort Walton Diagnostic Imaging Center Llc is an health care organization with primary practice located at 1112 Hospital Rd Suite C, Fort Walton Beach FL 32547-6742. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Radiology. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty. Fort Walton Diagnostic Imaging Center Llc can be contacted via phone (850) 862-7070, or through Mcmichael, Gary via phone (850) 862-7070.

Contact Information

Primary practice address
1112 Hospital Rd Suite C Fort Walton Beach FL 32547-6742
Phone: (850) 862-7070
Fax: (850) 862-0900
Website:
Map and Directions
Authorized official contact:
Name: Mcmichael, Gary
Phone: (850) 862-7070

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X HCC4489 Florida
Ambulatory Health Care Facilities / Radiology 261QR0200X HCC4489 Florida

Profile Details

NPI number 1619920642
LBN Legal business name Fort Walton Diagnostic Imaging Center Llc
DBA Doing business as
Authorized official Mcmichael, Gary
Entity Organization
Organization subpart 1 No
Enumeration date May 19th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619920642 NPPES
Florida Other V2837 BCBS FL PROVIDER NO.
Florida Other 7732283 BCBS FL PROVIDER NO.

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