MEDICARE: REAL IMAGING 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	261Q00000X	Clinic/Center	ME79727	FL
2	207RM1200X	Magnetic Resonance Imaging (MRI) Internal Medicine Physician	ME79727	FL

General Provider Information

NPI Number	:	1477070589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REAL IMAGING INC

Provider Business Mailing Address
First Line	:	4220 W COLONIAL DR STE 3
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-8175
Country	:	US
Telephone Number	:	954-243-3785
Fax Number	:

Provider Business Practice Location Address
First Line	:	4220 W COLONIAL DR STE 3
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-8175
Country	:	US
Telephone Number	:	954-243-3785
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEAN ROBERT CHARLOT
Credential	:	MD
Telephone Number	:	954-243-3785

Provider Enumeration Date	:	08/29/2017
Last Update Date	:	07/21/2022

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Directions to “REAL IMAGING INC ” Practice Location

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