Southeast Radiology Partners LTD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

SOUTHEAST RADIOLOGY PARTNERS LTD

Practice address

1600 Phillips Rd
Tallahassee, FL 32308-5304

Phone

(850) 878-4127

NPI assigned

May 15, 2024

Organization subpart

No

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

Authorized official

Name

John R Detelich

Title

Ceo

Phone

(850) 878-4127

Specialties & licenses 1

Addresses

Tax ID family

Southeast Radiology Partners LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Southeast Radiology Partners LTD

  • Vascular & Interventional Radiology Physician
  • Tallahassee, FL
  • NPI 1336866292
  NPD tax ID

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1508615360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25335",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336225335"
        },
        {
            "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": "SOUTHEAST RADIOLOGY PARTNERS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "DETELICH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-878-4127"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Soud
• Sassy Souders, APRN
• Soulistic Counseling & Therapeutic Services
• Jennifer Sousa
• Southeast Radiology Partners LTD
• Southeast Radiology Partners LTD
• Southeastern Behavioral Health, LLC
• Southeastern Center for Infectious Diseases PA
• Southeastern Dermatology, PA
• Southeastern Outpatient Surgery Center LLC

• Diagnostic Radiology Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.