Organization
TALLAHASSEE DIAGNOSTIC IMAGING LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R DETELICH (CEO)
(850) 878-4127
Entity
Organization
Contact information
Practice address
2459 MAHAN DR, TALLAHASSEE, FL 32308-2307
(850) 878-4127
Mailing address
PO BOX 21348, TAMPA, FL 33622-1348
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
03/30/2023
Last updated
03/30/2023
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