| Southeast Cardiovascular Imaging | |
|
1402 Oak St Melbourne FL 32901-3113 | |
| (321) 427-3089 | |
| Not Available |
| Full Name | Southeast Cardiovascular Imaging |
|---|---|
| Speciality | Clinic/center |
| Location | 1402 Oak St, Melbourne, Florida |
| Authorized Official Name and Position | Derrick Levasca Jenkins (PRESIDENT) |
| Authorized Official Contact | 3216370852 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Cardiovascular Imaging Po Box 560914 Rockledge FL 32956-0914 Ph: (321) 427-3089 | Southeast Cardiovascular Imaging 1402 Oak St Melbourne FL 32901-3113 Ph: (321) 427-3089 |
| NPI Number | 1417087495 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417087495 | NPI | - | NPPES |
| HCC6819 | Other | FL | HEALTH CARE CLINIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | HCC6819 (Florida) | Primary |
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