Provider Demographics
NPI:1497813034
Name:FLORIDA RADIOLOGY CENTERS LLC
Entity Type:Organization
Organization Name:FLORIDA RADIOLOGY CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF IMAGING SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:ZENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-557-2896
Mailing Address - Street 1:483 N SEMORAN BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3803
Mailing Address - Country:US
Mailing Address - Phone:407-557-2896
Mailing Address - Fax:
Practice Address - Street 1:483 N SEMORAN BLVD STE 104
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3803
Practice Address - Country:US
Practice Address - Phone:407-557-2896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH CARE SERVICES OF FLORIDA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-05
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV3259OtherBC/BS OF FLORIDA
FLV3259OtherBC/BS OF FLORIDA