Provider Demographics
NPI:1114918257
Name:PROSCAN IMAGING NAPLES LLC
Entity Type:Organization
Organization Name:PROSCAN IMAGING NAPLES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR, CORP. ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:AMAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-924-5174
Mailing Address - Street 1:1020 CROSSPOINTE DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-0918
Mailing Address - Country:US
Mailing Address - Phone:239-598-0035
Mailing Address - Fax:239-598-0038
Practice Address - Street 1:1020 CROSSPOINTE DR
Practice Address - Street 2:SUITE 3
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-0918
Practice Address - Country:US
Practice Address - Phone:239-598-0035
Practice Address - Fax:239-598-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271416700Medicaid
FL271416700Medicaid