Organization
PASSION QUEST, INC.
Active
Organization
PASSION QUEST, INC.
Active
Other names
Southeast Cardiovascular Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERRICK LEVASCA JENKINS I RCS (PRESIDENT)
(321) 637-0852
Entity
Organization
Contact information
Practice address
1402 OAK ST, MELBOURNE, FL 32901-3113
(321) 427-3089
Mailing address
PO BOX 560914, ROCKLEDGE, FL 32956-0914
(321) 427-3089
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC6819
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC6819
HEALTH CARE CLINIC
FL
Enumeration date
03/07/2007
Last updated
08/22/2020
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