Provider Demographics
NPI:1750544615
Name:DOLPHIN II DIAGOSTICS INC.
Entity type:Organization
Organization Name:DOLPHIN II DIAGOSTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-797-8461
Mailing Address - Street 1:1839 CENTRAL AVENUE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8900
Mailing Address - Country:US
Mailing Address - Phone:727-249-2548
Mailing Address - Fax:727-797-8467
Practice Address - Street 1:1700 N. MCMULLEN BOOTH RD UNIT B-3
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759
Practice Address - Country:US
Practice Address - Phone:727-249-2548
Practice Address - Fax:727-797-8467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty