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Active NPI 1366203655 Organization (Entity Type 2)

Panhandle Diagnostics Llc

Radiologic Technologist - Sonography • Crestview, FL

About Panhandle Diagnostics Llc NPI 1366203655 Summary

Panhandle Diagnostics Llc is a verified healthcare organization specializing in Radiologic Technologist - Sonography operating in Crestview, FL. Located at 502 S MAIN ST, this facility provides patient care and medical services under National Provider Identifier (NPI) 1366203655.

Administrative operations and authorized compliance are overseen by Kelley Moss (Ceo).

The facility is associated with 1 linked healthcare practitioner providing clinical services.

Facility Location & Contact Primary Location

Facility Address

502 S Main St

Crestview, FL 325364250

Telephone 8504012418

Authorized Official Information

Authorized Contact Name

Kelley Moss , RDMS/RVT

Title / Role

Ceo

Official Telephone

8503980108

Facility Classifications & Specialties

Radiologic Technologist - Sonography Primary Taxonomy

NUCC Taxonomy Code: 2471S1302X

A radiologic technologist who specializes in sonography and is appropriately educated and trained, consistent with nationally recognized standards, state statute, and facility policy in performance of ultrasounds, exam techniques, equipment protocols, radiation safety, and patient care.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

1 Linked
Dr. Joel Tate , DC NPI 1962726703

Chiropractor

Crestview, FL

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active January 23, 2024

NPI status registered as active in NPPES database

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Updated Practice Location January 23, 2024

Registered at 502 S MAIN ST, CRESTVIEW, FL 325364250 (Tel: 8504012418)

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Updated Business Mailing Address January 23, 2024

Registered at 5736 GRIFFITH CEMETERY RD, BAKER, FL 325318402 (Tel: 8504012418)

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Organization / Clinic Name Updated January 23, 2024

Operating as PANHANDLE DIAGNOSTICS LLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 23, 2024

Radiologic Technologist

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Initial NPI Registration & Enumeration January 23, 2024

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1366203655
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: January 23, 2024
Last Update: January 23, 2024

Mailing Address

5736 Griffith Cemetery Rd

Baker, FL 325318402

Phone: 8504012418

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.