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General NPI Number Information
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NPI Number | 1497625578
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Entity Type | Organization
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Legal Business Name | INSITE RADIOLOGY LLC
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 10618 DEERWOOD PARK BLVD STE 4
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City | JACKSONVILLE
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State | FL
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Zip | 32256-8198
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Country | US
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Telephone | 904-453-8995
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Fax |
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Provider Business Mailing Address
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Address Line | 10618 DEERWOOD PARK BLVD STE 4
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City | JACKSONVILLE
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State | FL
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Zip | 32256-8198
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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 | PRESIDENT
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Name | MARK GRNJA
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Credential |
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Telephone | 954-927-1776
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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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