Healthcare Provider Details

I. General information

NPI: 1558703751
Provider Name (Legal Business Name): ZOOMRAD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2013
Last Update Date: 07/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 N TAMIAMI TRL SUITE 210
SARASOTA FL
34236-5574
US

IV. Provider business mailing address

2 N TAMIAMI TRL SUITE 210
SARASOTA FL
34236-5574
US

V. Phone/Fax

Practice location:
  • Phone: 941-925-3490
  • Fax:
Mailing address:
  • Phone: 941-925-3490
  • 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: RON G HOCK
Title or Position: VP/GC
Credential: ESQ.
Phone: 941-925-3490