Provider Demographics
NPI:1609814656
Name:GARDENS RADIOLOGY ASSOCIATES, PA
Entity Type:Organization
Organization Name:GARDENS RADIOLOGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:MARTORELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-758-3607
Mailing Address - Street 1:PO BOX 1847
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1847
Mailing Address - Country:US
Mailing Address - Phone:877-440-0478
Mailing Address - Fax:317-705-5060
Practice Address - Street 1:3360 BURNS RD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4323
Practice Address - Country:US
Practice Address - Phone:615-625-5036
Practice Address - Fax:775-624-9774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060882300Medicaid
FL060882300Medicaid