Healthcare Provider Details

I. General information

NPI: 1114991973
Provider Name (Legal Business Name): RADIOLOGY ASSOCIATES OF ROCKLEDGE LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 LONGWOOD AVE
ROCKLEDGE FL
32955
US

IV. Provider business mailing address

PO BOX 919346
ORLANDO FL
32891-9346
US

V. Phone/Fax

Practice location:
  • Phone: 321-636-2211
  • Fax:
Mailing address:
  • Phone: 844-215-3269
  • Fax: 772-621-3184

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: DR. VICTOR E TORO
Title or Position: PRESIDENT
Credential: MD
Phone: 844-215-3269