Provider Demographics
NPI:1821163296
Name:DOPPLER MOBILE DIAGNOSTIC SERVICES INC
Entity Type:Organization
Organization Name:DOPPLER MOBILE DIAGNOSTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-819-9424
Mailing Address - Street 1:9440 OSCEOLA DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-4325
Mailing Address - Country:US
Mailing Address - Phone:727-819-9424
Mailing Address - Fax:727-819-0515
Practice Address - Street 1:9440 OSCEOLA DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-4325
Practice Address - Country:US
Practice Address - Phone:727-819-9424
Practice Address - Fax:727-819-0515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6803261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14416403OtherCITRUS H.C--PINELLAS CNTY
FL14416404OtherCITRUS H.C POLK COUNTY
FL14416401OtherCITRUS H.C PASCO COUNTY
FL14416402OtherCITRUS H.C HILLSBOR CNTY
FLV3103OtherBCBS OF FLA
FL=========OtherHUMANA
FL14416404OtherCITRUS H.C POLK COUNTY
FL=========OtherCHOICECARE NETWORK