Healthcare Provider Details

I. General information

NPI: 1457332355
Provider Name (Legal Business Name): CITRUS RADIOLOGY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
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

PO BOX 830941
BIRMINGHAM AL
35283-0941
US

V. Phone/Fax

Practice location:
  • Phone: 352-688-8200
  • Fax:
Mailing address:
  • Phone: 727-793-9300
  • 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. RICCARDO DE GIROLAMI
Title or Position: PRESIDENT
Credential: M. D.
Phone: 352-688-8200