Provider Demographics
NPI:1093925174
Name:SUMMIT DIAGNOSTIC CORP.
Entity Type:Organization
Organization Name:SUMMIT DIAGNOSTIC CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRANKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-676-9746
Mailing Address - Street 1:8381 BUTLER GREENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4539
Mailing Address - Country:US
Mailing Address - Phone:561-676-9746
Mailing Address - Fax:
Practice Address - Street 1:1499 FOREST HILL BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6050
Practice Address - Country:US
Practice Address - Phone:561-676-9746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3211112251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care