1932554920 NPI number — DIME DIAGNOSTIC PRECISION ULTRASOUND

Table of content: (NPI 1932554920)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932554920 NPI number — DIME DIAGNOSTIC PRECISION ULTRASOUND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIME DIAGNOSTIC PRECISION ULTRASOUND
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932554920
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7427 VICTORIA CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32835-6013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-540-8617
Provider Business Mailing Address Fax Number:
407-540-8617

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1213 N CENTRAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KISSIMMEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34741-4407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-692-8737
Provider Business Practice Location Address Fax Number:
407-540-8617
Provider Enumeration Date:
04/27/2016

Additional Information

Authorized Official

Authorized Official Last Name:
THOMPSON
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
ANTHONY
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
407-692-8737

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , with the licence number:  ME110269 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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