MEDICARE: DIAGNOSTIC RADIOLOGY SPECIALISTS

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	ME51729	FL

General Provider Information

NPI Number	:	1982771101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIAGNOSTIC RADIOLOGY SPECIALISTS

Provider Business Mailing Address
First Line	:	4133 WOODLANDS PKWY
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-3462
Country	:	US
Telephone Number	:	727-781-3888
Fax Number	:	727-781-3881

Provider Business Practice Location Address
First Line	:	4133 WOODLANDS PKWY
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-3462
Country	:	US
Telephone Number	:	727-781-3888
Fax Number	:	727-781-3881

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MANUEL S ROSE
Credential	:	MD
Telephone Number	:	727-781-3888

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	08/22/2020

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