Healthcare Provider Details

I. General information

NPI: 1649458704
Provider Name (Legal Business Name): COUNTY RADIOLOGY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10461 QUALITY DR
SPRING HILL FL
34609-9634
US

IV. Provider business mailing address

1132 SE KINGS BAY DR
CRYSTAL RIVER FL
34429-4645
US

V. Phone/Fax

Practice location:
  • Phone: 352-688-8200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. MICHAEL HERRON
Title or Position: PRESIDENT
Credential: MD
Phone: 727-793-9300