MEDICARE: IMAGING CENTER, PC

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	784	VI

General Provider Information

NPI Number	:	1467570358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMAGING CENTER, PC

Provider Business Mailing Address
First Line	:	4500 SION FARM
Second Line	:	SUITE 4B, ISLAND MEDICAL CTR.
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4423
Country	:	US
Telephone Number	:	340-778-5305
Fax Number	:	340-778-2778

Provider Business Practice Location Address
First Line	:	4500 SION FARM
Second Line	:	ISLAND MEDICAL CTR., STE 5
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4423
Country	:	US
Telephone Number	:	340-778-5305
Fax Number	:	340-778-2778

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANGELO KEITH GALIBER
Credential	:	M.D.
Telephone Number	:	340-778-5305

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	03/19/2021

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