Healthcare Provider Details

I. General information

NPI: 1699348565
Provider Name (Legal Business Name): RADIOLOGY ASSOCIATES OF SOUTH FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2021
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 JUDSON RD
LONGVIEW TX
75601-5113
US

IV. Provider business mailing address

PO BOX 85519
CHICAGO IL
60689-5519
US

V. Phone/Fax

Practice location:
  • Phone: 305-363-3286
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

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