Provider Demographics
NPI:1952548273
Name:AMERICAN DIAGNOSTIC CARE SERVICES LLC
Entity Type:Organization
Organization Name:AMERICAN DIAGNOSTIC CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:HEGAZY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-902-9296
Mailing Address - Street 1:1914 FRANKFORD AVE
Mailing Address - Street 2:APT 201
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3006
Mailing Address - Country:US
Mailing Address - Phone:407-902-9296
Mailing Address - Fax:
Practice Address - Street 1:11111 PANAMA CITY BEACH PKWY
Practice Address - Street 2:SUITE 10
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407-2448
Practice Address - Country:US
Practice Address - Phone:407-902-9296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Multi-Specialty