Provider Demographics
NPI:1932554920
Name:DIME DIAGNOSTIC PRECISION ULTRASOUND
Entity Type:Organization
Organization Name:DIME DIAGNOSTIC PRECISION ULTRASOUND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:407-692-8737
Mailing Address - Street 1:7427 VICTORIA CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6013
Mailing Address - Country:US
Mailing Address - Phone:407-540-8617
Mailing Address - Fax:407-540-8617
Practice Address - Street 1:1213 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4407
Practice Address - Country:US
Practice Address - Phone:407-692-8737
Practice Address - Fax:407-540-8617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110269261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty