Provider Demographics
NPI:1225484413
Name:DIAGNOSTIC OUTPATIENT CENTERS INC
Entity Type:Organization
Organization Name:DIAGNOSTIC OUTPATIENT CENTERS INC
Other - Org Name:DOCS MOBILE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-896-2202
Mailing Address - Street 1:400 12TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-1120
Mailing Address - Country:US
Mailing Address - Phone:727-896-2202
Mailing Address - Fax:727-822-6407
Practice Address - Street 1:400 12TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-1120
Practice Address - Country:US
Practice Address - Phone:727-896-2202
Practice Address - Fax:727-822-6407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0207XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile Mammography
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL242633OtherFDA