Healthcare Provider Details
I. General information
NPI: 1861688863
Provider Name (Legal Business Name): NORTH FLORIDA RADIOLOGY, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/24/2007
Last Update Date: 09/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6716 NW 11TH PL
GAINESVILLE FL
32605-4215
US
IV. Provider business mailing address
PO BOX 147026
GAINESVILLE FL
32614-7026
US
V. Phone/Fax
- Phone: 352-331-9729
- Fax: 352-331-0136
- Phone: 352-331-9729
- Fax: 352-331-0136
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAMES
B
VOGLER
III
Title or Position: CEO/PRESIDENT
Credential: MD
Phone: 352-331-9729