Provider Demographics
NPI:1982930566
Name:APPELKVIST, FRED (ARDMS)
Entity Type:Individual
Prefix:MR
First Name:FRED
Middle Name:
Last Name:APPELKVIST
Suffix:
Gender:M
Credentials:ARDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 SW 57TH AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2163
Mailing Address - Country:US
Mailing Address - Phone:305-266-9051
Mailing Address - Fax:305-267-8884
Practice Address - Street 1:1700 SW 57TH AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2163
Practice Address - Country:US
Practice Address - Phone:305-266-9051
Practice Address - Fax:305-267-8884
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL59694247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist