Organization
DESTIN REGIONAL IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHUN W CHEN MD (AUTHORIZED OFFICIAL)
(850) 278-3555
Entity
Organization
Contact information
Practice address
7800 US HIGHWAY 98 W, MIRAMAR BEACH, FL 32550-7228
(850) 278-3555
(850) 278-3562
Mailing address
PO BOX 1977, INDIANAPOLIS, IN 46206-1977
(855) 410-3201
(855) 853-5098
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME86615
FL
2085R0202X
Diagnostic Radiology Physician
ME89464
FL
2085R0204X
Vascular & Interventional Radiology Physician
ME74820
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272337900
—
FL
Enumeration date
09/29/2005
Last updated
05/27/2022
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