Provider Demographics
NPI:1215226808
Name:GLOBAL MOBILE DIAGNOSTICS OF WESLEY CHAPEL, INC
Entity Type:Organization
Organization Name:GLOBAL MOBILE DIAGNOSTICS OF WESLEY CHAPEL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MITZE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-994-5455
Mailing Address - Street 1:2304 CRESTOVER LN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6788
Mailing Address - Country:US
Mailing Address - Phone:813-994-5455
Mailing Address - Fax:
Practice Address - Street 1:2304 CRESTOVER LN
Practice Address - Street 2:SUITE 102
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6788
Practice Address - Country:US
Practice Address - Phone:813-994-5455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile