Healthcare Provider Details

I. General information

NPI: 1104252592
Provider Name (Legal Business Name): RADIOLOGY ASSOCIATES OF FLORIDA OFFICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2013
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 UNIVERSITY SQUARE DR
TAMPA FL
33612-5513
US

IV. Provider business mailing address

PO BOX 85499
CHICAGO IL
60689-5499
US

V. Phone/Fax

Practice location:
  • Phone: 813-253-2721
  • 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 State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN VAUGHN
Title or Position: AO
Credential:
Phone: 629-317-1465