| Organization Name: | SANDESTIN RADIOLOGY SERVICES, LLC |
| NPI Number: | 1427475664 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANGEL BARBER (ADMINISTRATOR) |
| Mailing Address: | 400 Audubon Dr Miramar Beach |
| State: | FL US |
| Postal Code: | 325504594 |
| Phone Number: | 8502676767 |
| Fax Number: | |
| NPI Enumeration Date: | 03/26/2014 |
| NPI Last Update Date: | 03/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |