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General NPI Number Information
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NPI Number | 1790050847
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Entity Type | Organization
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Legal Business Name | KEY RADIOLOGY ASSOCIATES LLC
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Dates
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Enumeration Date | 03/21/2012
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 5832 TIDEWOOD AVE
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City | SARASOTA
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State | FL
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Zip | 34231-3132
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Country | US
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Telephone | 941-927-0684
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Fax |
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Provider Business Mailing Address
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Address Line | 5832 TIDEWOOD AVE
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City | SARASOTA
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State | FL
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Zip | 34231-3132
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Country | US
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Telephone | 941-927-0684
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Fax |
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Authorized Official
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Title or Position | MGM
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Name | DR. PAUL J MACCHI
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Credential | MD
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Telephone | 941-927-0684
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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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