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General NPI Number Information
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NPI Number | 1376965236
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Entity Type | Organization
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Legal Business Name | VIRTUAL RADIOLOGY INC
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Dates
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Enumeration Date | 01/13/2014
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2520 W BAY DR
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City | LARGO
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State | FL
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Zip | 33770-1935
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Country | US
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Telephone | 727-586-0545
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Fax | 727-586-0547
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Provider Business Mailing Address
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Address Line | 2520 W BAY DR
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City | LARGO
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State | FL
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Zip | 33770-1935
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Country | US
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Telephone | 727-586-0545
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Fax | 727-586-0547
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Authorized Official
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Title or Position | OWNER/RADIOLOGIST
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Name | ABNER MARTIN LANDRY III
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Credential | MD
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Telephone | 727-586-0545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | ME56269
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number | ME56269
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License Number State | FL
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