Healthcare Provider Details
I. General information
NPI: 1083458582
Provider Name (Legal Business Name): CONQUEST IMAGING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/20/2024
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9450 W COLONIAL DR
OCOEE FL
34761-6800
US
IV. Provider business mailing address
9450 W COLONIAL DR
OCOEE FL
34761-6800
US
V. Phone/Fax
- Phone: 407-863-4900
- Fax: 321-247-5900
- Phone: 407-863-4900
- Fax: 321-247-5900
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LOAKHNAUTH
RAMKISHUN
Title or Position: OWNER
Credential: M.D.
Phone: 407-575-6390