MEDICARE: EAST CENTRAL FLORIDA OUTPATIENT IMAGING, 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
1	2085R0204X	Vascular & Interventional Radiology Physician

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

General Provider Information

NPI Number	:	1457927469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST CENTRAL FLORIDA OUTPATIENT IMAGING, LLC

Provider Business Mailing Address
First Line	:	PO BOX 678454
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75267-8454
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3048 S ATLANTIC AVE STE 102
Second Line	:
City	:	DAYTONA BEACH SHORES
State	:	FL
Zip	:	32118-6102
Country	:	US
Telephone Number	:	386-274-7118
Fax Number	:	386-276-6173

Authorized Official
Title or Position	:	CEO
Name	:	LISA ADAMS
Credential	:
Telephone Number	:	386-274-7118

Provider Enumeration Date	:	06/01/2021
Last Update Date	:	09/04/2024

Similar Medicare Providers

1497036917 — LISA M LIBBY RPH
Practice Location Address:

3004 S ATLANTIC AVE
DAYTONA BEACH SHORES, FL
32118-6102

Practice Phone: 386-788-6344
Practice Fax: 386-788-8703

1699059717 — MR. VINCENT JOHN VINTAGE PHARMD
Practice Location Address:

3004 S ATLANTIC AVE
DAYTONA BEACH SHORES, FL
32118-6102

Practice Phone: 386-788-6344
Practice Fax: 386-788-8703

1114296274 — STEVEN ROBERT SHAFTER RPH
Practice Location Address:

3004 S ATLANTIC AVE
DAYTONA BEACH SHORES, FL
32118-6102

Practice Phone: 386-788-6344
Practice Fax:

1326443060 — PUBLIX SUPER MARKETS INC
Practice Location Address:

3044 S ATLANTIC AVE
DAYTONA BEACH SHORES, FL
32118-6102

Practice Phone: 386-788-7330
Practice Fax: 386-615-1638

1528075504 — WALGREEN CO
Practice Location Address:

3004 S ATLANTIC AVE
DAYTONA BEACH, FL
32118-6102

Practice Phone: 386-788-6344
Practice Fax:

1093308504 — HN UCC LLC
Practice Location Address:

3048 S ATLANTIC AVE
DAYTONA BEACH, FL
32118-6102

Practice Phone: 423-531-1330
Practice Fax:

Directions to “EAST CENTRAL FLORIDA OUTPATIENT IMAGING, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.