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General NPI Number Information
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NPI Number | 1407809262
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Entity Type | Organization
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Legal Business Name | RADIOLOGY REGIONAL CENTER P A
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 14551 HOPE CENTER LOOP STE 100
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City | FORT MYERS
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State | FL
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Zip | 33912-4705
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Country | US
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Telephone | 239-936-2316
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Fax | 239-936-3099
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Provider Business Mailing Address
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Address Line | 3660 BROADWAY
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City | FORT MYERS
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State | FL
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Zip | 33901-8005
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Country | US
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Telephone | 239-936-2316
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Fax | 239-834-6106
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Authorized Official
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Title or Position | CEO
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Name | DARIUS BISKUP
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Credential | MD
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Telephone | 239-936-2316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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