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Organization

DIAGNOSTIC PORTABLE IMAGING INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRUCE D COTTI RT(R)ARRT (PRESIDENT/OWNER)
(321) 984-8001
Entity
Organization

Contact information

Practice address
5201 BABCOCK ST NE, SUITE 2, PALM BAY, FL 32905-4637
(321) 984-8001
(321) 728-0523
Mailing address
5201 BABCOCK ST NE, SUITE 2, PALM BAY, FL 32905-4637
(321) 984-8001
(321) 728-0523

Taxonomy

Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
V1919
BLUE SHIELD IDTF
FL
Enumeration date
12/28/2007
Last updated
06/05/2008
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