Provider Demographics
NPI:1407433048
Name:FLORIDA IMAGING SPECIALISTS, PA
Entity Type:Organization
Organization Name:FLORIDA IMAGING SPECIALISTS, PA
Other - Org Name:PRECISION IMAGING, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KETANG
Authorized Official - Middle Name:H
Authorized Official - Last Name:MODI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-310-2957
Mailing Address - Street 1:3420 WASHINGTON LN
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4627
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7313 INTERNATIONAL PL STE 80
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34240-8406
Practice Address - Country:US
Practice Address - Phone:941-830-4404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty