Provider Demographics
NPI:1336322825
Name:NUCLEAR SPECIALISTS INC
Entity Type:Organization
Organization Name:NUCLEAR SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HANEY
Authorized Official - Last Name:SOULE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-320-1889
Mailing Address - Street 1:4155 SAINT JOHNS PKWY
Mailing Address - Street 2:#1400
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6391
Mailing Address - Country:US
Mailing Address - Phone:407-320-1889
Mailing Address - Fax:407-320-0820
Practice Address - Street 1:4155 SAINT JOHNS PKWY
Practice Address - Street 2:#1400
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6391
Practice Address - Country:US
Practice Address - Phone:407-320-1889
Practice Address - Fax:407-320-0820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC7788OtherAHCA HEALTH