MEDICARE: NEURO IMAGING INSTITUTE OF WINTER PARK, LTD

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	174400000X	Specialist

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	:	1730173089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEURO IMAGING INSTITUTE OF WINTER PARK, LTD

Provider Business Mailing Address
First Line	:	PO BOX 550
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32790-0550
Country	:	US
Telephone Number	:	407-478-1550
Fax Number	:	407-478-2495

Provider Business Practice Location Address
First Line	:	2111 GLENWOOD DR
Second Line	:	SUITE 101
City	:	WINTER PARK
State	:	FL
Zip	:	32792-3328
Country	:	US
Telephone Number	:	407-478-1550
Fax Number	:	407-478-2495

Authorized Official
Title or Position	:	OWNER
Name	:	RAJENDRA M. VAZIRANI
Credential	:	MD
Telephone Number	:	770-400-6393

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	11/04/2025

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