Provider Demographics
NPI:1477070589
Name:REAL IMAGING INC
Entity Type:Organization
Organization Name:REAL IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:CHARLOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-243-3785
Mailing Address - Street 1:4220 W COLONIAL DR STE 3
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-8175
Mailing Address - Country:US
Mailing Address - Phone:954-243-3785
Mailing Address - Fax:
Practice Address - Street 1:4220 W COLONIAL DR STE 3
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-8175
Practice Address - Country:US
Practice Address - Phone:954-243-3785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79727207RM1200X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RM1200XAllopathic & Osteopathic PhysiciansInternal MedicineMagnetic Resonance Imaging (MRI)Group - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty