NPIMap

Organization Active NPI

Tallahassee Diag Imaging Ctr LTD

  • Diagnostic Radiology Physician
  • Tallahassee, FL
National Provider Identifier
1205376191
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
TALLAHASSEE DIAG IMAGING CTR LTD
Practice address
1600 Phillips Rd
Tallahassee, FL 32308-5304
Phone
(850) 878-4127
NPI assigned
Feb 27, 2017
Organization subpart
Yes
Parent organization
TALLAHASSEE DIAG IMAGING CTR LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Detelich
Title
Ceo
Phone
(850) 878-4127

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1600 Phillips Rd
Tallahassee, FL 32308-5304

Mailing address

PO Box 21348
Tampa, FL 33622-1348
Phone (800) 841-4236

National Provider Directory

National Provider Directory
Tax ID family
Tallahassee Diag Imaging Ctr LTD4 organizations share this tax ID, including this one
Part of
Tallahassee Diag Imaging Ctr LTD

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1205376191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21348",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336221348",
            "telephone_number": "800-841-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PHILLIPS RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085304",
            "telephone_number": "850-878-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALLAHASSEE DIAG IMAGING CTR LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TALLAHASSEE DIAG IMAGING CTR LTD",
        "enumeration_date": "2017-02-27",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "DETELICH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-878-4127"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.