| Organization Name: | TALLAHASSEE DIAGNOSTIC IMAGING LTD |
| NPI Number: | 1700830890 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARA FOWLER (CEO) |
| Mailing Address: | 15 Council Moore Rd Crawfordville |
| State: | FL US |
| Postal Code: | 323273117 |
| Phone Number: | 8509261259 |
| Fax Number: | 8509261679 |
| NPI Enumeration Date: | 05/22/2006 |
| NPI Last Update Date: | 10/17/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471C3401X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Computed Tomography |
| Taxonomy Definition: | |