INSTITUTE OF DIAGNOSTIC IMAGINGLLC NPI 1982670022

NPI Information

NPI: 1982670022
Provider Name: INSTITUTE OF DIAGNOSTIC IMAGING,LLC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

CLIA Number: 10D2231601

Address:
424 RACETRACK RD NW
FT WALTON BEACH, FL
ZIP 32547
Phone: (850) 314-7575
Get Directions

INSTITUTE OF DIAGNOSTIC IMAGING,LLC is a diagnostic radiology radiology in Ft Walton Beach, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. INSTITUTE OF DIAGNOSTIC IMAGING,LLC NPI is 1982670022. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

424 RACETRACK RD NW
FT WALTON BEACH, FL
ZIP 32547-556
Phone: (850) 314-7575
Fax: (850) 314-7494

The provider's authorized official is Laurie Borgstrom .
The authorized official title is Office Manager and has the following contact phone number (850) 314-7575.

The CLIA number assigned to this NPI record is 10D2231601 - other - outpatien diagnostic imag with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/28/2006 and was last updated on 6/20/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	602617	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	268363600	MEDICAID	FLORIDA
2	DB5733	MEDICARE PIN	FLORIDA
3	DB5733	OTHER	FLORIDA	RAILROAD MEDICARE
4	42622Y	MEDICARE PIN	FLORIDA
5	09981Y	MEDICARE PIN	FLORIDA
6	34904	MEDICARE PIN	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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