Organization
MOBILE EKG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER MICHAEL RUSSELL PARAMEDIC (CEO/DIRECTOR)
(941) 979-9930
Entity
Organization
Contact information
Practice address
20281 XITA AVE, PORT CHARLOTTE, FL 33952-1234
(941) 979-9930
Mailing address
20281 XITA AVE, PORT CHARLOTTE, FL 33952-1234
(941) 979-9930
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
95714
PA
Other
Enumeration date
01/21/2016
Last updated
01/21/2016
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