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General NPI Number Information
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NPI Number | 1063400729
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Entity Type | Organization
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Legal Business Name | RADIOLOGY IMAGING ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 1673 MASON AVE SUITE 305
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-5515
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Country | US
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Telephone | 386-274-7118
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Fax | 386-274-6173
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Provider Business Mailing Address
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Address Line | 1673 MASON AVE SUITE 305
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-5515
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Country | US
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Telephone | 386-274-6143
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Fax | 386-274-6173
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Authorized Official
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Title or Position | EXECUTIVE ADMINISTRATOR
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Name | AL FALCO
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Credential |
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Telephone | 386-274-7118
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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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