Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Dec 7, 2005
License(s)
ME110828 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 4500 SAN PABLO RD S | Jacksonville, FL 32224-1865 | |
| LOCATION | 4500 SAN PABLO RD S | Jacksonville, FL 32224-1865 | 904-953-2000 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.