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General NPI Number Information
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NPI Number | 1982709788
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Entity Type | Organization
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Legal Business Name | ALTAMONTE SPRINGS DIAGNOSTIC IMAGING INC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 01/30/2012
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Provider Practice Location Address
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Address Line | 882 S KIRKMAN RD SUITE 103-104
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City | ORLANDO
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State | FL
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Zip | 32811-2600
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Country | US
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Telephone | 407-288-8160
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Fax | 407-288-8170
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Provider Business Mailing Address
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Address Line | 1150 S. SEMORAN BLVD SUITE C
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City | ORLANDO
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State | FL
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Zip | 32807-1424
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Country | US
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Telephone | 407-482-5253
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Fax | 407-482-5254
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD I LANDAU
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Credential | M.D.
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Telephone | 407-482-5253
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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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