Provider Demographics
NPI:1457332355
Name:CITRUS RADIOLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:CITRUS RADIOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICCARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:DE GIROLAMI
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:352-688-8200
Mailing Address - Street 1:PO BOX 830941
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0941
Mailing Address - Country:US
Mailing Address - Phone:727-793-9300
Mailing Address - Fax:
Practice Address - Street 1:10461 QUALITY DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-9634
Practice Address - Country:US
Practice Address - Phone:352-688-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL99320OtherBCBS
FL99320Medicare PIN
FLCA6907 RR MCRMedicare PIN