Provider Demographics
NPI:1679561526
Name:MEDICAL EVALUATORS INC
Entity Type:Organization
Organization Name:MEDICAL EVALUATORS INC
Other - Org Name:GULF IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HAI
Authorized Official - Middle Name:
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:RT (MR)(R)
Authorized Official - Phone:850-784-0545
Mailing Address - Street 1:406 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4602
Mailing Address - Country:US
Mailing Address - Phone:850-784-0545
Mailing Address - Fax:850-215-4045
Practice Address - Street 1:406 W 19TH ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4602
Practice Address - Country:US
Practice Address - Phone:850-784-0545
Practice Address - Fax:850-215-4045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5703261QM1200X, 261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV2907OtherBLUECROSS BLUE SHIELD
FL057843601Medicaid
FL057843601Medicaid