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NPI Code Detail

MEDICARE: ADVANCED RADIOLOGY IMAGING ASSOCIATES LLC

MEDICARE: ADVANCED RADIOLOGY IMAGING ASSOCIATES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2DE1300OTHERFLGROUP RAILROAD NUMBER

General Provider Information

NPI Number : 1073591681
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED RADIOLOGY IMAGING ASSOCIATES LLC
Provider Business Mailing Address
First Line : 13300-56 S. CLEVELAND AVE
Second Line : PMB # 239
City : FORT MYERS
State : FL
Zip : 33907-7150
Country : US
Telephone Number : 239-454-2742
Fax Number : 239-466-2742
Provider Business Practice Location Address
First Line : 13731 METROPOLIS AVE
Second Line :
City : FT MYERS
State : FL
Zip : 33912-7150
Country : US
Telephone Number : 239-454-2742
Fax Number : 239-466-2742
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : SAURIN J SHAH
Credential : MD
Telephone Number : 239-454-2742
Provider Enumeration Date : 01/04/2006
Last Update Date : 05/01/2009

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Directions to “ADVANCED RADIOLOGY IMAGING ASSOCIATES LLC ” Practice Location

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