Healthcare Provider Details

I. General information

NPI: 1700873981
Provider Name (Legal Business Name): AMIN RADIOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

922 N CITRUS AVE
CRYSTAL RIVER FL
34428-3409
US

IV. Provider business mailing address

922 N CITRUS AVE
CRYSTAL RIVER FL
34428-3409
US

V. Phone/Fax

Practice location:
  • Phone: 352-795-9200
  • Fax: 352-795-6460
Mailing address:
  • Phone: 352-795-9200
  • Fax: 352-795-6460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAMALESH A AMIN
Title or Position: PRESIDENT
Credential: MD
Phone: 352-795-9200