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Organization
NATIONAL P.E.T. SCAN PINELLAS, LLC
Active
Organization
NATIONAL P.E.T. SCAN PINELLAS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGIE FAYE AUSTIN (ADMINISTRATIVE ASSISTANT)
(904) 358-8441
Entity
Organization
Contact information
Practice address
6600 66TH ST N, STE B, PINELLAS PARK, FL 33781-5040
(904) 358-8441
(727) 471-2197
Mailing address
6622 SOUTHPOINT DR S, SUITE 360, JACKSONVILLE, FL 32216-8014
(904) 358-8441
(904) 358-2288
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
HCC5686
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202977
WELLCARE
FL
01
—
2918309
AETNA HMO
FL
01
—
3540719-001
CIGNA
FL
01
—
593688943
TRICARE
FL
01
—
7642379
AETNA NON HMO
FL
01
—
V2570
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
05/24/2005
Last updated
12/05/2012
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