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NPI Code Detail

MEDICARE: FLORIDA RADIOLOGY ASSOCIATES PA

MEDICARE: FLORIDA RADIOLOGY ASSOCIATES PA
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
12085B0100XBody Imaging Physician
22085N0700XNeuroradiology Physician
32085N0904XNuclear Radiology Physician
42085P0229XPediatric Radiology Physician
52085R0204XVascular & Interventional Radiology Physician
62085U0001XDiagnostic Ultrasound Physician
72085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100552OTHERFLBCBS GROUP NUMBER

General Provider Information

NPI Number : 1558440388
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA RADIOLOGY ASSOCIATES PA
Provider Business Mailing Address
First Line : PO BOX 150505
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32715-0505
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 N LAKEMONT AVE
Second Line :
City : WINTER PARK
State : FL
Zip : 32792-3273
Country : US
Telephone Number : 407-767-0433
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : CHARLES MAY
Credential :
Telephone Number : 407-767-5306
Provider Enumeration Date : 11/03/2006
Last Update Date : 08/07/2007

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Directions to “FLORIDA RADIOLOGY ASSOCIATES PA ” Practice Location

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