Healthcare Provider Details

I. General information

NPI: 1497625578
Provider Name (Legal Business Name): INSITE RADIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10618 DEERWOOD PARK BLVD STE 4
JACKSONVILLE FL
32256-8198
US

IV. Provider business mailing address

10618 DEERWOOD PARK BLVD STE 4
JACKSONVILLE FL
32256-8198
US

V. Phone/Fax

Practice location:
  • Phone: 904-453-8995
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK GRNJA
Title or Position: PRESIDENT
Credential:
Phone: 954-927-1776