Healthcare Provider Details

I. General information

NPI: 1407497647
Provider Name (Legal Business Name): PROSCAN IMAGING NAPLES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2019
Last Update Date: 09/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8340 SIERRA MEADOWS BLVD STE 103
NAPLES FL
34113-7328
US

IV. Provider business mailing address

8340 SIERRA MEADOWS BLVD STE 103
NAPLES FL
34113-7328
US

V. Phone/Fax

Practice location:
  • Phone: 239-598-0035
  • Fax:
Mailing address:
  • Phone: 239-598-0035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAREN E AMAYA
Title or Position: COO
Credential:
Phone: 513-924-5174