Provider Demographics
NPI:1912908328
Name:SEBASTIAN RADIOLOGY ASSOCIATES INC
Entity Type:Organization
Organization Name:SEBASTIAN RADIOLOGY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:H
Authorized Official - Last Name:DION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-410-0155
Mailing Address - Street 1:3725 11TH CR
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4804
Mailing Address - Country:US
Mailing Address - Phone:772-562-0163
Mailing Address - Fax:772-567-5631
Practice Address - Street 1:3725 11TH CR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4804
Practice Address - Country:US
Practice Address - Phone:772-562-0163
Practice Address - Fax:772-567-5631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty