Provider Demographics
NPI:1841514254
Name:HEALTH DIAGNOSTICS OF ORLANDO, LLC
Entity type:Organization
Organization Name:HEALTH DIAGNOSTICS OF ORLANDO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-396-1050
Mailing Address - Street 1:8 CORPORATE CENTER DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-3193
Mailing Address - Country:US
Mailing Address - Phone:631-396-1050
Mailing Address - Fax:
Practice Address - Street 1:4521 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-9037
Practice Address - Country:US
Practice Address - Phone:239-514-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)