Provider Demographics
NPI:1518236124
Name:PASADENA IMAGING ASSOCIATES PA
Entity Type:Organization
Organization Name:PASADENA IMAGING ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANGITA
Authorized Official - Middle Name:THAKOR
Authorized Official - Last Name:KAPADIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-560-9359
Mailing Address - Street 1:5931 BAYVIEW CIR S
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33707-3929
Mailing Address - Country:US
Mailing Address - Phone:727-560-9359
Mailing Address - Fax:
Practice Address - Street 1:5931 BAYVIEW CIR S
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:FL
Practice Address - Zip Code:33707-3929
Practice Address - Country:US
Practice Address - Phone:727-560-9359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME665612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty