Healthcare Provider Details

I. General information

NPI: 1639806664
Provider Name (Legal Business Name): RADIOLOGY OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2022
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 N DEAN RD STE 110
ORLANDO FL
32825-3767
US

IV. Provider business mailing address

106 N DEAN RD STE 110
ORLANDO FL
32825-3767
US

V. Phone/Fax

Practice location:
  • Phone: 407-384-7388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SRINIVAS SEELA
Title or Position: PARTNER
Credential: MD
Phone: 386-336-6877