Provider Demographics
NPI:1225407430
Name:PREMIER DIAGNOSTIC IMAGING LLC
Entity Type:Organization
Organization Name:PREMIER DIAGNOSTIC IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIZARRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-694-8132
Mailing Address - Street 1:2415 UNIVERSITY PKWY STE 112
Mailing Address - Street 2:UNIVERSITY HEALTH PARK BLDG 3
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2809
Mailing Address - Country:US
Mailing Address - Phone:407-694-8132
Mailing Address - Fax:888-972-9784
Practice Address - Street 1:2415 UNIVERSITY PKWY STE 112
Practice Address - Street 2:UNIVERSITY HEALTH PARK BLDG 3
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2809
Practice Address - Country:US
Practice Address - Phone:407-694-8132
Practice Address - Fax:888-972-9784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty