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Organization

FLORIDA EAST COAST IMAGING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH FLYNN (PRESIDENT)
(727) 793-9300
Entity
Organization

Contact information

Practice address
5005 PORT ST JOHN PKWY, PORT ST JOHN, FL 32927-4305
(321) 636-9393
Mailing address
PO BOX 15659, CLEARWATER, FL 33766-5659
(727) 793-9300

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
278373800
FL
01
DH0129
RR MCR
FL
Enumeration date
03/21/2007
Last updated
05/21/2008
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