Healthcare Provider Details

I. General information

NPI: 1396589180
Provider Name (Legal Business Name): UNIVERSAL RADIOLOGY PARTNERS OF SOUTH CAROLINA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 UNIVERSITY PKWY
AIKEN SC
29801-6302
US

IV. Provider business mailing address

2326 S CONGRESS AVE STE 1C
WEST PALM BEACH FL
33406-7652
US

V. Phone/Fax

Practice location:
  • Phone: 803-641-5000
  • 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: DANIELA GHIRAGOSSIAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 561-268-6509