Provider Demographics
NPI:1023187572
Name:DIAGNOSTIC IMAGING CONSULTANTS OF ST PETERSBURG PA
Entity Type:Organization
Organization Name:DIAGNOSTIC IMAGING CONSULTANTS OF ST PETERSBURG PA
Other - Org Name:DIAGNOSTIC IMAGING CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:THORPE
Authorized Official - Suffix:
Authorized Official - Credentials:DC DACBR
Authorized Official - Phone:727-579-2500
Mailing Address - Street 1:5136 CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707
Mailing Address - Country:US
Mailing Address - Phone:727-579-2500
Mailing Address - Fax:727-579-3433
Practice Address - Street 1:5136 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707
Practice Address - Country:US
Practice Address - Phone:727-579-2500
Practice Address - Fax:727-579-3433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL41235111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Single Specialty