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FORT WALTON DIAGNOSTIC IMAGING CENTER LLC
NPI 1619920642
Clinic/Center - Radiology in Fort Walton Beach, FL

Active since May 19, 2006
1112 HOSPITAL RD, SUITE C, FORT WALTON BEACH, FL 32547(850) 862-7070(850) 862-0900 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Fort Walton Diagnostic Imaging Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORT WALTON DIAGNOSTIC IMAGING CENTER LLC (NPI 1619920642) is a healthcare organization registered as a radiology in Fort Walton Beach, Florida and active in the NPI registry since May 2006. The organization lists Gary Mcmichael, Member, as its authorized official.

NPPES Registry Identity

NPI1619920642
Entity TypeOrganization
Primary Taxonomy261QR0200X
Legal Business NameFORT WALTON DIAGNOSTIC IMAGING CENTER LLC
Location Address1112 HOSPITAL RD, SUITE CFort Walton Beach, FL 32547-6742
Mailing Address1112 Hospital Rd, Suite CFort Walton Beach, FL 32547-6742 · (850) 862-7070 · Fax (850) 862-0900
Phone(850) 862-7070
Fax(850) 862-0900
Organization SubpartNo
Authorized OfficialGary McmichaelMember · (850) 862-7070
Enumeration DateMay 19, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1619920642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · RadiologyAmbulatory Health Care Facilities
Taxonomy Code261QR0200X
License✔ Licensed in FL · HCC4489
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X · License HCC4489 (FL)
1112 HOSPITAL RD, Fort Walton Beach, FL 32547
Open in Google Maps ↗

Other Identifiers 2

OtherV2837FL · Bcbs Fl Provider No.
Other7732283FL · Aetna Provider No.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OKALOOSA WALTON UROLOGY PA
Urology
1112 HOSPITAL RD, UNIT A
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 682-6333
NAVARRE OPEN MRI LLC
Clinic/Center (Magnetic Resonance Imaging (MRI))
1112 HOSPITAL RD, SUITE B
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 862-7070
HAMPTON DIALYSIS LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
1112 HOSPITAL RD
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 864-4850
FT WALTON OPEN MRI LLC
Clinic/Center (Magnetic Resonance Imaging (MRI))
1112 HOSPITAL RD, SUITE B
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 862-7070

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fort Walton Diagnostic Imaging Center LLC's NPI number?

The NPI number for Fort Walton Diagnostic Imaging Center LLC is 1619920642. It was assigned to this organization in the NPPES registry on May 19, 2006.

Where is Fort Walton Diagnostic Imaging Center LLC located?

Fort Walton Diagnostic Imaging Center LLC is located at 1112 Hospital Rd Suite C, Fort Walton Beach, FL 32547. The listed phone number is (850) 862-7070.

What is Fort Walton Diagnostic Imaging Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, with taxonomy code 261QR0200X.

When was this NPI record last updated?

The NPPES record for Fort Walton Diagnostic Imaging Center LLC was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.