| Viera Diagnostic Center Llc | |
|
7000 Spyglass Ct Suite 260 Viera FL 32940-8288 | |
| (321) 254-7880 | |
| (321) 254-7707 |
| Full Name | Viera Diagnostic Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7000 Spyglass Ct, Viera, Florida |
| Authorized Official Name and Position | Francis Abayomi Olomu (ADMINISTRATOR) |
| Authorized Official Contact | 3212547880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Viera Diagnostic Center Llc 7000 Spyglass Ct Suite 260 Viera FL 32940-8288 Ph: (321) 254-7880 | Viera Diagnostic Center Llc 7000 Spyglass Ct Suite 260 Viera FL 32940-8288 Ph: (321) 254-7880 |
| NPI Number | 1659347037 |
|---|---|
| Provider Enumeration Date | 02/27/2006 |
| Last Update Date | 05/22/2008 |
| Medicare PECOS PAC ID | 1153304126 |
|---|---|
| Medicare Enrollment ID | O20070529000435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659347037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | HCC5570 (Florida) | Primary |
| Provider Name | Carlene A Gentles |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538106927 PECOS PAC ID: 8022156421 Enrollment ID: I20091104000668 |
| Provider Name | Allen O Powell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124091913 PECOS PAC ID: 4284622085 Enrollment ID: I20110510000525 |
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