MEDICARE: FLORIDA DIAGNOSTIC IMAGING CENTER INC

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
1	2085R0202X	Diagnostic Radiology Physician		FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	470000877	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	V2193	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	55301	OTHER	FL	BCBS ALABAMA
6	7143079	OTHER	FL	AETNA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235197930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA DIAGNOSTIC IMAGING CENTER INC

Provider Business Mailing Address
First Line	:	PO BOX 31003
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33631-3003
Country	:	US
Telephone Number	:	727-823-2188
Fax Number	:	727-828-0723

Provider Business Practice Location Address
First Line	:	4511 N DAVIS HWY STE 1-B
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32503-2720
Country	:	US
Telephone Number	:	850-484-8454
Fax Number	:	850-484-7754

Authorized Official
Title or Position	:	OWNER / PROVIDER
Name	:	DR. CHINTAN DESAI
Credential	:	MD
Telephone Number	:	850-484-8454

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	05/05/2026

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Directions to “FLORIDA DIAGNOSTIC IMAGING CENTER INC ” Practice Location

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