Organization
RAD ONE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID COURSON MS.RTR. (PARTNER)
(941) 815-1103
Entity
Organization
Contact information
Practice address
12462 KROME AVE, PORT CHARLOTTE, FL 33981-1327
(941) 815-1103
(239) 541-5445
Mailing address
12462 KROME AVE, PORT CHARLOTTE, FL 33981-1327
(941) 815-1103
(239) 541-5445
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
CRT39038
FL
247100000X
Radiologic Technologist
Primary
CRT8522
FL
332BC3200X
Customized Equipment (DME)
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1880149214156
RESALE TAX ID
FL
01
—
P02000132080
CORPORATION ID
FL
Enumeration date
07/01/2011
Last updated
07/01/2011
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