Healthcare Provider Details

I. General information

NPI: 1306801097
Provider Name (Legal Business Name): FLORIDA KEYS RADIOLOGY ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 W SEAVIEW DR
MARATHON FL
33050
US

IV. Provider business mailing address

6415 LAKE WORTH RD STE 102
GREENACRES FL
33463-3009
US

V. Phone/Fax

Practice location:
  • Phone: 305-743-6299
  • Fax: 305-743-2921
Mailing address:
  • Phone: 561-331-0808
  • Fax: 561-237-6034

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: MELINDA KAY KOSCIANSKI
Title or Position: BUSINESS MANAGER
Credential:
Phone: 404-819-2456