MEDICARE: GARDENS 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
1	2085R0202X	Diagnostic 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	:	1609814656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARDENS RADIOLOGY ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	PO BOX 1847
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46206-1847
Country	:	US
Telephone Number	:	877-440-0478
Fax Number	:	317-705-5060

Provider Business Practice Location Address
First Line	:	3360 BURNS RD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4323
Country	:	US
Telephone Number	:	615-625-5036
Fax Number	:	775-624-9774

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MANUEL G. MARTORELL
Credential	:
Telephone Number	:	561-758-3607

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	02/02/2024

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