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NPI Code Detail

MEDICARE: OSCEOLA RADIOLOGY ASSOCIATES PA

MEDICARE: OSCEOLA RADIOLOGY ASSOCIATES PA
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

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DA1725OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
134765OTHERFLBC BS OF FLORIDA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407838808
Entity Type Code : Organization
Provider Name (Legal Business Name) : OSCEOLA RADIOLOGY ASSOCIATES PA
Provider Business Mailing Address
First Line : PO BOX 160923
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32716-0923
Country : US
Telephone Number : 866-674-7933
Fax Number :
Provider Business Practice Location Address
First Line : 700 W OAK ST
Second Line :
City : KISSIMMEE
State : FL
Zip : 34741-4924
Country : US
Telephone Number : 407-846-2266
Fax Number : 407-518-3158
Authorized Official
Title or Position : SR. DIRECTORE, RCM
Name : SUSAN C HOLMAN
Credential :
Telephone Number : 866-674-7933
Provider Enumeration Date : 11/19/2005
Last Update Date : 01/14/2022

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Directions to “OSCEOLA RADIOLOGY ASSOCIATES PA ” Practice Location

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