MEDICARE: STAR RADIOLOGY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1366305963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAR RADIOLOGY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 340426
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33694-0426
Country	:	US
Telephone Number	:	813-609-2579
Fax Number	:

Provider Business Practice Location Address
First Line	:	5102 W HOMER AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-7523
Country	:	US
Telephone Number	:	813-609-2579
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DARREN BUONO
Credential	:	MD
Telephone Number	:	858-232-4532

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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