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General NPI Number Information
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NPI Number | 1013727106
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Entity Type | Organization
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Legal Business Name | INTELLIRAD IMAGING, LLC
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 4610 PEA RIDGE CONNECTOR RD
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City | MILTON
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State | FL
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Zip | 32571-2797
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Country | US
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Telephone | 850-304-0600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7623
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City | NAPLES
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State | FL
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Zip | 34101-7623
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | RONALD JOSEPH
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Credential | MD
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Telephone | 305-712-7229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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