Healthcare Provider Details

I. General information

NPI: 1396759684
Provider Name (Legal Business Name): RADIOLOGY ASSOCIATES OF PENSACOLA, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W MORENO ST
PENSACOLA FL
32501-2316
US

IV. Provider business mailing address

PO BOX 622047
ORLANDO FL
32862-2047
US

V. Phone/Fax

Practice location:
  • Phone: 850-434-4011
  • Fax:
Mailing address:
  • Phone: 850-432-6851
  • Fax: 850-438-6821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAREN SCHELL
Title or Position: CEO
Credential:
Phone: 850-432-6851