Organization
PRIME RADIOLOGY OF WINTER HAVEN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS BROWN M.D (MEDICAL DIRECTOR)
(850) 624-5666
Entity
Organization
Contact information
Practice address
7524 CYPRESS GARDENS BLVD, WINTER HAVEN, FL 33884-3200
(850) 624-5666
(321) 348-5777
Mailing address
7524 CYPRESS GARDENS BLVD, WINTER HAVEN, FL 33884-3200
(850) 624-5666
(321) 348-5777
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME62144
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME62144
LICENSE
FL
Enumeration date
02/27/2015
Last updated
04/19/2017
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