Organization
UPSCALE ULTRASOUND & MOBILE 3D 4D, LLC
Active
Parent organization
UPSCALE ULTRASOUND
Organization subpart
Yes
Provider details
NPI number
Legal business name
UPSCALE ULTRASOUND
Authorized official
LEAH R CARROLL RDMS (OWNER)
(904) 465-9062
Entity
Organization
Contact information
Practice address
145 HILDEN RD, STE 113, PONTE VEDRA, FL 32081-8401
(904) 465-9062
Mailing address
145 HILDEN RD, STE 113, PONTE VEDRA, FL 32081-8401
(904) 465-9062
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
134780
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871951244
INDIVIDUAL NPI
FL
Enumeration date
10/21/2016
Last updated
10/21/2016
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