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Organization

FLORIDA DIAGNOSTIC IMAGING CENTER

Active
Other names
Panama City Beach Imaging
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DANIEL J SCHAEFER (COO)
(770) 300-0101
Entity
Organization

Contact information

Practice address
16201 PANAMA CITY BEACH PKWY, SUTIE 101, PANAMA CITY BEACH, FL 32413-5301
(850) 233-2868
(850) 233-2278
Mailing address
3480 PRESTON RIDGE RD STE 600, CREDENTIALING DEPT, ALPHARETTA, GA 30005-5462
(770) 300-0101
(770) 300-0429

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
E3017B
MEDICARE IDTF
FL
Enumeration date
05/02/2006
Last updated
09/23/2013
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