Organization
NEW LIFE IMAGING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN A BROWN RDMS (OWNER/OPERATOR)
(772) 785-8000
Entity
Organization
Contact information
Practice address
501 NW LAKE WHITNEY PLACE, SUITE #106, PORT ST LUCIE, FL 34986-3443
(772) 785-8000
(772) 785-8150
Mailing address
501 NW LAKE WHITNEY PLACE, SUITE #106, PORT ST LUCIE, FL 34986-3443
(772) 785-8000
(772) 785-8150
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
510001100
—
FL
01
—
V2026
BLUE SHIELD
FL
Enumeration date
10/17/2006
Last updated
07/30/2009
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